The Speech Pathology Department at Austin Health has undertaken and led an ambitious project to implement a standard pathway across the organisation for patients choosing to eat and drink with acknowledged risk (EDAR). The project has been underpinned by the Speech Pathology Australia EDAR guideline using an IHI improvement science framework.
A working group led by Speech Pathology was convened with members from medical, nursing and allied health disciplines. Change ideas were developed as a bundle of care and tested during a pilot phase before being ramped up across the organisation. Run charts of tested change ideas will be presented.
Extensive consultation has occurred with consumers and hospital-wide committees including the Nutrition and Hydration Committee, which provided governance for the project. All committees and consumers have applauded the patient-centred values of the project and provided resounding endorsement of the outcomes.
For the first time an escalation plan has been developed by our medical colleagues and endorsed by the Deteriorating Patient Committee. Strategies to deal with the very real concerns of moral distress in staff working with patients choosing to EDAR will also be explored.
The development of a standard procedure to guide the management of patients choosing to EDAR at Austin Health has ensured that these patients embark on a shared decision making process and can make clearly informed choices. Furthermore, members of the MDT now have a clearer understanding of their roles and responsibilities and are better equipped to support patients choosing to EDAR.

1. Patients choosing to EDAR need to have a standard clinical pathway to support their choices
2. Extensive consultation across the organisation's key stakeholders and organisation-wide committees and consumers has been crucial in achieving success
3. The moral distress of staff working with patients choosing to EDAR is another essential consideration