Performance improvement projects consist of four steps, describe how the improvement project steps used in your example in detail. 1. L.efine the improvement goal 2. Analyze current practices 3. Design and implement improvements 4. Measure success Provide your own conclusion on the success of the initiative and any recommendations you would have in terms of other quality improvement tools that could be used, improvements to methodology and areas for further quality review. Identifying early palliative care requirements and recognising the end of life need advance care planning. Educating families and staff on ACP and end-of-life care options, better preparing staff for ACP talks, providing staff skills training and guidelines, and LTC staff initiating systematic, improved communication with primary care are all methods to improve ACP. According to my perspective, other quality improvement tools that could be used is "Six Sigma which is a systematic, data-driven improvement approach whose goal is the near-elimination of defects from every product, process, and transaction