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Aim or Purpose of the Presentation To share a ward-based quality improvement initiative aimed at increasing Advance Care Planning (ACP) completion in a newly established tertiary hospital, using the ACP-F framework to guide patient identification and promote integration of ACP into routine clinical care.Background Woodlands Health, Singapore’s newest tertiary hospital, began operations in May 2024. A baseline review showed that only 1% of inpatients had a completed Preferred Plan of Care (PPC), despite 30–50% of patients being appropriate for ACP. In Singapore, ACP includes General ACP (GACP) for future preferences and PPC for current care decisions. The ACP-F framework—Advanced Organ Failure, Advanced Cancer, Progressive Neurodegenerative Diseases, and Frailty—was used to screen patients suitable for PPC. This project was motivated by the need to embed ACP early into a new system’s clinical workflows and culture.Method A six-month quality improvement project began in September 2024 in a 40-bedded general medical ward. Interventions included the development of screening workflows using the ACP-F framework, mentoring junior doctors, engaging ward-based palliative resource nurses, and reinforcing ACP in daily multidisciplinary rounds. Staff received education and bedside coaching to enhance skills and confidence.By March 2025, the ACP/PPC completion rate in the ward rose from 1% to a peak of 4.4%. Although the original 10% target was not met, a culture shift was evident, with more consistent patient screening and initiation of discussions. Temporary dips occurred during festive periods and bed crunch due to system-level pressures. Institution-wide, 279 ACP discussions (226 PPCs, 53 GACPs) were completed. Nurses led 48% of all ACPs, with APNs driving PPC. General ACP was primarily facilitated by nurses (64%), followed by allied health (32%) and doctors (4%).Unique Contribution This submission provides insight into the early integration of ACP in a new tertiary hospital using a structured, condition-based screening approach (ACP-F). It demonstrates the impact of engaging nurses and embedding ACP into daily workflows. It also highlights real-world barriers such as staffing pressure and ward transitions, often overlooked in early implementation phases.Implications This experience suggests that ACP integration is feasible from the outset in new healthcare systems. Embedding ACP into routine care, supported by a multidisciplinary approach and nurse empowerment, enhances sustainability. Policymakers and clinical leaders should consider structured screening tools and nurse-led facilitation models to scale ACP uptake and normalize conversations across care settings.