Sidebar: North Carolina’s Process for Developing Our COVID-19 Vaccine Plan

### Background There are no national standards about the timing of initiating ACP discussions. It is suggested that may be initiated following diagnosis a life-limiting condition, with change in treatment focus, or multiple hospital admissions. was unknown how many patients dying at specialist cancer centre had been involved prior to death, and what stage their illness this commenced. Methods This baseline retrospective audit. The population sampled all inpatient adult deaths over two-month period 2019 centre. Medical records Co-ordinate My Care (Electronic urgent care plan) were reviewed from six months patient death for evidence We anticipated 70% would have death. Results 36 deaths. 89% these non-curative disease. 63% DNAR discussion. Of patients, 22% discussion final admission versus 78% who during admission. 44% preferred place (PPC) and/or (PPD). only 31% discussions compared 69% Conclusions most common form discussion, followed by PPC/PPD. vast majority occurred as opposed outpatient clinics previous concern time conversations being initiated, patients' options future wishes already restricted less chance achieved. audit will inform an education programme encourage earlier broader