Authors (including presenting author) :
NG YS(1), CHENG HW(2),LAU CC(2), TAM EMYY(2), CHEUNG H F(2), CHU H M(2), YIP WL(3),CHAN CH(3), HWANG LM(3), LAU YM(4), KAM KW(5), CHENG SM(5), CHENG YS(5), KUNG KM(5), LAU OY(5), LING HS(6), CHAN OM(6), PANG YH(7), HO LY(7)
Affiliation :
(1) FM&PHC, NTWC
(2) M&G, TMH/POH/TSWH
(3) Clinical Oncology, TMH
(4) CCD, NTWC
(5) PRCs, NTWC
(6) MSSU, TMH/TMH
(7) PA&DM, NTWC
Introduction :
The recent legislation on Advance Decision on life-sustaining treatment Ordinance in HK marks a significant advancement in empowering patients’ autonomy, to ensure their end-of-life wishes are being respected. However, advance medical directives (AMD) remain a new idea for many healthcare workers and community partners, creating challenges in adhering to the latest protocol and guidelines, and assessing patients' decision-making capacity. As such, the New Territories West Cluster (NTWC) launched a medical-social collaboration initiative aimed at enhancing understanding and execution of AMD.
Objectives :
․ Develop effective strategies for promoting and implementing AMD in hospitals
․ Enhance healthcare staff’s competence on AMD implementation
Methodology :
The initiative composed two stages: planning and implementation. The planning stage included:
․ Needs Assessment: Conducted surveys and interviews to identify needs and challenges faced by healthcare staff in implementing AMD.
․ Multi-disciplinary Profession Platform: Reviewed the latest AMD practices and discussed on strategic planning for healthcare professional education.
The implementation stage covered:
․ Roving Exhibition: Collaborated with non-government organizations (NGOs) to establish roving exhibitions offering educational materials and social services information on AMD and Advance Care Planning.
․ AMD Trainings: Organized symposium and training sessions to equip healthcare staff with knowledge about the legal, ethical and clinical aspects of AMD implementation.
․ Consultation and Support: A multidisciplinary team would offer continuous support during AMD implementation.
․ Evaluation: Evaluated utilizing mixed-method assessment for continuous improvement.
Result & Outcome :
From January to December 2024, the initiative successfully reached over 2,000 staff and engaged 20 NGOs. Data indicated a significant increase in staff’s AMD knowledge especially on legal and ethical aspects. Meanwhile, confidence in handling patients’ AMD requests was reported increased. Qualitative feedback revealed a deeper appreciation among staff for patients’ autonomy and the importance of cultural sensitivity in end-of-life care. In conclusion, the initiative effectively addressed AMD implementation challenges in hospitals. Through our medical-social collaboration platform, future efforts should focus on continued education and expanding support networks to ensure compliance and understanding of AMD among healthcare professionals and community partners.
