Honoring Choices Wisconsin

Transcription

1 Click to edit Master title style Honoring Choices Wisconsin UW Health Advance Care Planning Initiative Geriatrics Clinic Pilot Click to Pilot edit Master Resultstitle style 65 Facilitated ACP Conversations Goal was Facilitated Conversations Per Month Number of Facilitated Conversations March April May June July August Total # Facilated Conversations

2 Click to Pilot edit Master Resultstitle style Accepted ACP Consultation 69 Refused ACP Consultation 33 Maybe/Interested 4 Total patients approached 106 4% ACP Recruitment 31% 65% Accepted ACP Consultation Refused ACP Consultation Maybe/Interested Click to Pilot edit Master Resultstitle style Overwhelmingly positive feedback from Patients and their Agents 96% of patients surveyed said discussion was helpful or very helpful Created Infrastructure for sustainability and expansion Patient Satisfaction (Total patient sampled: 49) Discussion helpful Number of patients not at all

3 Click to edit Pilot Master Design title style Steering Committee Role: Pilot Support, System Wide Implementation Planning, Pilot Promotion Staff Involved Facilitators, UW Health Leadership, IT Support, Provider Champions, HIM Representative, Patient Advocate (PFAC) Pilot Design Team Role: Pilot Design and Implementation Staff Involved Facilitators (Multi-Disciplinary) Schedulers Providers Medical Assistants Clinic/Unit Manager Social Work Manager Quality Dept Analyst (assist with process logistics, track data) UW Health Leadership Champion Patient Advocate (from Patient and Family Advisory Council) Click to edit Pilot Master Designtitle style Process of Creating Weekly meetings Process Mapping Creation of new workflows Configuring Data Collection Logistics Staff Education Recruitment Strategies Target: Primary Care Patients at the Geriatric Clinic Providers introduce ACP to existing patients Facilitators introduce ACP to new patients Goal: Facilitated Conversations During 6 Month Pilot (03/13-09/13) Barriers Identified at Start Adding responsibilities to provider and staff workloads How to make workflows efficient IT Support Provider buy in 3

4 Click What to edit Worked Master Well title style Multi-Disciplinary involvement Defined and Attainable Recruitment Strategy Delineating Workflow process at outset of implementation Additional ACP conversations occurred with family members Consistent regularity of staff meetings (i.e. once weekly) Scheduler role - organizer for referrals and data tracking Good SW presence - witnesses were readily available Clear system for communication and coordination Shared leadership responsibilities among pilot team members Strong support from Wisconsin Medical Society, Respecting Choices, and UW Health Leadership Challenges Encountered Click to edit Master title style EMR Functionality Lack of Consistency with preparing patients adequately for ACP conversations Time intensive, (planning, ongoing organizational needs, and facilitating) Data Collection Logistics 4

5 Click to Lessons edit Master Learned title style It Takes a Village The following roles are all crucial for ongoing success ACP Coordinator Scheduler Site Specific Provider Champions Facilitators Providers (primary referral source) Medical Assistants Clinic/Unit Manager Dedicated EMR Support Personnel Quality Dept Analyst (assist with process logistics, track data) UW Health Leadership Champions (System Wide) Patient Representative/Advocate Click to Lessons edit Master Learned title style Physician/Provider investment Needs to precede implementation of ACP Initiative Plan to accommodate need for on site witnesses Important to collect data track process, test effectiveness of initiative, ensure that patients do not slip through the cracks. 5

6 Recommendations for Improvements Click to edit Master title style Increased EMR support is essential Improve Patient Handouts, both for general educational purposes and for ACP appointment preparation Review needs of data collection needs now, so it can be well integrated into all ACP Initiative expansion Create a Checklist or Outline format document for Facilitators for both initial conversations and ACP Appointments Recommendations for Improvements Click to edit Master title style Create a Playbook for facilitators Increase opportunities for UW Health Staff to participate in Advance Care Planning. Create a Computer Based Training Including Advance Care Planning responsibilities into job descriptions 6

7 Click Plan to edit Moving Master Forward title style Expansion to new sites Next HIV Clinic Complex Case Managers (Patient Resources) Then Internal Medicine (University Station Clinic) Cancer Clinics Geriatrics Specialty Clinics 10 more Facilitators trained 3 Facilitator Instructors being trained Internal Facilitator Training Program ACP Coordinator Position Click to edit Thank Master you! title style We are so grateful for the many years of dedication the Respecting Choices Program at Gunderson Lutheran Hospital has devoted to improving patient care through Advance Care Planning. Thank you for paving the way. Also, a big thank you to the Wisconsin Medical Society for making Advance Care Planning a Statewide priority. Your efforts will positively impact people s health and their care for generations to come. 7