Table 3 A summary of thematic findings from the cross-case analysis

Effectiveness

1) Increased awareness and understanding of advance care planning

1) Increased knowledge and understanding of advance care planning

2) An opportunity to build on existing skills

2) Reassurance about advance care planning

3) Increased confidence for advance care planning

3) Permission to be involved in advance care planning

4) Preparedness for advance care planning conversations with families

4) Confidence and empowerment about advance care planning

5) Increased willingness to talk about advance care planning

5) Feeling involved and valued as a care partner

Adoption

Content that was well received

1) A comprehensive overview of advance care planning

1) Key points of advance care planning explained

2) Information about self-care

2) Support resources

3) Audio-visual website design

3) Vibrant website design

4) Inclusion of different perspectives and voices

4) Gentle tone

5) Appropriate language and tone

5) Videos

Suggestions for improvement

1) Facilitated blended learning

1) Supplementary printed information

2) Assessment of learning

2) Clarify COVID-19 focus

3) Evidence of training

3) Clarify legal aspects

4) Advanced training options

5) Real life examples

Implementation

Barriers

1) Computer skills

1) Emotional content

2) Time

2) No access to technology

Facilitators

1) Ensuring the website is easy to use

1) Simple information

2) Working in groups

2) Trustworthy information

3) Bitesize information

Maintenance

1) Advance care planning policies reviewed

1) Prompted conversations with relative in the nursing home

2) Advance care planning paperwork reviewed

2) Prompted conversations with care staff

3) Shared learning between colleagues

4) Desire to roll out training