The Assisted Decision Making (Capacity) Act 2015 in Action: Ireland East Hospital Group Marks 1 Year Milestone

Background In Ireland, the Assisted Decision Making (ADM) (Capacity) Act 2015 was enacted in April 2023. The Act supports a new progressive rights-based system of supported decision making that requires all healthcare staff to make some changes in their clinical practice. The Health Service Executive (HSE) developed an implementation plan to support organisations to meet the legislative requirements of the Act. Methods Assessing implementation progress across ten acute hospital sites using the HSE Implementation Framework (HSE, 2015). Progress was evaluated across seven thematic areas: Operational Implementation, Communication Strategy, Learning Strategy, Alignment of Current Operational Approaches, Quality and Compliance, Risk Consideration and Resources. Results Significant progress has been made across all seven domains with strong engagement from all sites. Acknowledging variation is important given the breadth of services provided across these hospitals. Implementation is an ongoing process given the cultural changes needed, the resource implications and the interplay with external stakeholders. Conclusion Further development in key areas includes tailoring education to suit the specific needs of individual units within hospitals and embedding this education into existing education programmes. It is crucial to monitor resource requirements and adapt to regulatory requirements to ensure compliance. Moving forward sustained efforts will be necessary to embed the principles of supported decision making firmly within healthcare delivery, ultimately promoting dignity and autonomy for all patients.