---
title: "End-of-life planning policies in NSW public health facilities: a comparative document review"
id: "pubmed-42604849"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42604849"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42604849/"
doi: "10.1071/AH26057"
published_at: "2026-09-03T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# End-of-life planning policies in NSW public health facilities: a comparative document review
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42604849
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42604849/)
- **DOI:** [10.1071/AH26057](https://doi.org/10.1071%2FAH26057)
- **Published At:** 2026-09-03T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Objective: The review aimed to identify differences in availability, content, definitions, and terminology in New South Wales (NSW) Health policy documents related to **end-of-life planning**. - Methods: A desktop/scoping comparative analysis was conducted across the intranet sites of 15 NSW Local Health Districts (LHDs). Documents relevant to end-of-life planning were identified and analysed using the READ approach. - Documents obtained: 105 documents were collected; 49 (46%) explicitly discussed or mentioned **resuscitation plans**, **advance care plans**, or **advance care directives**. These 49 included 36 LHD-level, 9 facility-level, and 5 state-level documents. - Definitions and terminology: Among the 49 documents, 26 (53%) used the term **advance care plan**, 24 (48%) used **advance care directive**, and 16 (32%) used **resuscitation plan**. A greater proportion of documents did not align with the state policy PD_2014_030. - Variation: The review found significant variation in terminology, abbreviations, and definitions across documents and between LHDs and facilities. - Geographic differences: Availability and accessibility of documents varied by remoteness: 61% of documents were from major cities, with inner-regional 11.4%, outer-regional 15.9%, remote 2.3%, and very-remote 9.1%. - Conclusion: There are disparities in the number and type of end-of-life planning documents available to clinicians across LHDs and between regional/remote areas and major cities. Document-to-document inconsistencies suggest state policies may not sufficiently meet local needs and underscore the need for accepted, uniform definitions at the statewide policy level. - Keywords highlighted by the authors included clinical deterioration, comparative document review, critical care nursing, governance, in-hospital cardiac arrest, policy documents, quality and safety in healthcare, rapid response systems, and resuscitation planning.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliations * 1 Clinical Emergency Response Systems, Royal Prince Alfred Hospital, Camperdown, NSW, Australia. * 2 The University of Sydney Faculty of Medicine and Health, Sydney, NSW, Australia. * 3 Intensive Care Unit, Royal Prince Alfred Hospital, Camperdown, NSW, Australia. * 4 Sydney Local Health District, Camperdown, NSW, Australia. * 5 The Daffodil Centre, Sydney, NSW, Australia. * PMID: **42604849** * DOI: [ 10.1071/AH26057 ](https://doi.org/10.1071/ah26057) Item in Clipboard Comparative Study # End-of-life planning and its governing policies: a comparison of New South Wales public health facility documents Douglas James Billing et al. Aust Health Rev. 2026. Show details Display options Display options Format Abstract PubMed PMID Aust Health Rev Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Aust+Health+Rev%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Aust+Health+Rev%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42604849/) . 2026 Sep 3;50(3):AH26057. doi: 10.1071/AH26057. ### Authors [Douglas James Billing](https://pubmed.ncbi.nlm.nih.gov/?term=Billing+DJ&cauthor_id=42604849)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42604849/#short-view-affiliation-1 "Clinical Emergency Response Systems, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42604849/#short-view-affiliation-2 "The University of Sydney Faculty of Medicine and Health, Sydney, NSW, Australia."), [Georgina Learmonth](https://pubmed.ncbi.nlm.nih.gov/?term=Learmonth+G&cauthor_id=42604849)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42604849/#short-view-affiliation-3 "Intensive Care Unit, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42604849/#short-view-affiliation-4 "Sydney Local Health District, Camperdown, NSW, Australia."), [Grace Edwards](https://pubmed.ncbi.nlm.nih.gov/?term=Edwards+G&cauthor_id=42604849)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42604849/#short-view-affiliation-4 "Sydney Local Health District, Camperdown, NSW, Australia."), [Kate White](https://pubmed.ncbi.nlm.nih.gov/?term=White+K&cauthor_id=42604849)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42604849/#short-view-affiliation-2 "The University of Sydney Faculty of Medicine and Health, Sydney, NSW, Australia.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42604849/#short-view-affiliation-4 "Sydney Local Health District, Camperdown, NSW, Australia.")[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42604849/#short-view-affiliation-5 "The Daffodil Centre, Sydney, NSW, Australia.") ### Affiliations * 1 Clinical Emergency Response Systems, Royal Prince Alfred Hospital, Camperdown, NSW, Australia. * 2 The University of Sydney Faculty of Medicine and Health, Sydney, NSW, Australia. * 3 Intensive Care Unit, Royal Prince Alfred Hospital, Camperdown, NSW, Australia. * 4 Sydney Local Health District, Camperdown, NSW, Australia. * 5 The Daffodil Centre, Sydney, NSW, Australia. * PMID: **42604849** * DOI: [ 10.1071/AH26057 ](https://doi.org/10.1071/ah26057) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Objective:** This desktop/scoping document review aimed to determine differences in availability, content, definitions, and terminology used in NSW Health policy documents that pertained to end-of-life planning. **Methods:** A desktop/scoping comparative analysis of identified documents from the 15 NSW Local Health District (LHD) intranet sites was conducted to identify policy documents that describe elements of or were relevant to end-of-life planning. Of those that pertained to end-of-life planning, data were extracted and analysed using the READ approach. **Results:** A total of 105 documents were obtained, with 49 (46%) being identified as discussing or mentioning resuscitation plans, advance care plans, or advance care directives (36 LHD, 9 facility-level, and 5 state-level). The frequency of definitions identified in the 49 documents included 26 (53%) using advance care plan, 24 (48%) using advance care directive, and 16 (32%) using resuscitation plan. The greater proportion of these did not align with the state policy PD_2014_030. Significant variation was observed in terminology and abbreviations among all documents. Using the Australian Statistical Geography Standard Remoteness Structure of geographical remoteness, there are differences in the availability and accessibility between major cities (61% of documents) versus inner-regional/outer-regional/remote/very-remote-areas (11.4 /15.9/2.3/9.1%). **Conclusion:** This review highlights variations in the number and type of documents available to clinicians across LHDs. There were evident disparities in the number of documents available on LHD intranets as well as between regional-remote NSW when compared to major cities. When viewed in conjunction with document-to-document inconsistencies in terminology and definitions, these findings highlight the possibility that current state policies are not meeting the needs of LHDs and hospitals at the local level. This underscores the importance of accepted, uniform definitions within the context of statewide policymaking. **Keywords:** clinical deterioration; comparative document review; critical care nursing; end-of-life planning; governance; in-hospital cardiac arrest; policy documents; quality and safety in healthcare; rapid response systems; resuscitation planning. © 2026 The Author(s) (or their employer(s)). Published by CSIRO Publishing. 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