Aust Health Rev. 2026 Sep 3;50(3):AH26057. doi: 10.1071/AH26057.
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.
PMID:42604849 | DOI:10.1071/AH26057
