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After informed consent was obtained, patients were enrolled and asked to nominate a family member as an appropriate contact. Non-research staff carried out the randomisation using sealed envelopes containing allocation cards assigned by random numbers. Intervention patients received formal advance care planning from a trained facilitator (nurse or allied health worker) using the Respecting Patient Choices model12 (see web extra on bmj.com).

This programme, developed at the Austin Hospital in Melbourne, Australia, is based on the Respecting Choices programme21 28 and involves a coordinated approach to advance care planning whereby trained non-medical facilitators, in collaboration with treating doctors, assist patients and their families to reflect on the patient’s goals, values, and beliefs, and to discuss and document their future choices about health care.

Advance care planning aimed to assist patients to reflect on their goals, values, and beliefs; to consider future medical treatment preferences; to appoint a surrogate; and to document their wishes.Main outcome measures The primary outcome was whether a patient’s end of life wishes were known and respected.Other outcomes included patient and family satisfaction with hospital stay and levels of stress, anxiety, and depression in relatives of patients who died.Data collected at enrolment included age, sex, admission diagnosis, the existence of a form requesting no resuscitation, whether the patient had a surrogate, and whether the patient already had any wishes on end of life care, including life prolonging treatment or cardiopulmonary resuscitation.At or immediately after hospital discharge the patient or the family member (if the patient had died) completed a discharge questionnaire.