We’re proud to share some exciting news! The Washington State Medical Association awarded The Vancouver Clinic with its 2017 William O. Robertson Patient Safety Awards of Achievement for our efforts to standardize and improve advanced care planning at The Vancouver Clinic.
Advance care planning is the process of making decisions about the kind of care that you would want to receive if you became unable to speak for yourself. A survey by The Conversation Project showed that while 90 percent of Americans believe talking about end-of-life care is important, only about 30 percent have actually done so.
Over the past two years, Dr. Lynda Tang, Kathryn Pence, PA-C, and a team of other TVC staff have been hard at work building a program to integrate advance care planning into everyday care. Dr. Tang and her team looked to Honoring Choices Pacific Northwest for guidance. Using their nationally recognized model, she and her team tackled two key obstacles to effective advance care planning: starting the conversation and recording patients’ wishes.
Starting the conversation
They began by offering a small group of patients the opportunity to meet one-on-one with a trained facilitator in a “conversation room.” Designed to resemble a living room, this comfortable and safe space helps facilitators to guide patients through conversations about values, goals and what it means to live.
These conversations help patients talk about what type of care they will or will not want at the end of their lives. If they’re ready, patients have the option to complete legal forms (such as a durable power of attorney).
The reaction from patients has been overwhelmingly positive. On average, patients who met with a facilitator rated their meetings 4.7 out of 5 in terms of usefulness and value. Dr. Tang and her team have grown the program to include more patients and providers, with the goal of making this a service available to all patients.
Recording patients’ wishes
On the back end, Dr. Tang and her team led efforts to make it easier for providers to review patients’ advance care directives. These documents—including living wills, durable power of attorney forms and Physician Orders for Life-Sustaining Treatment—describe what care patients want or don’t want. Across the U.S., advance care directives are available to providers only about 25 percent of the time, according to the National Academy of Sciences, Institute of Medicine. To ensure your wishes are known, your medical record now has a section dedicated to documenting your wishes about advance care planning.
If you want help making your wishes about end-of-life care known, read Dr. Tang’s article in The Reflector, or visit theconversationproject.org to download a free starter kit.
Dr. Lynda Tang and Kathryn Pence, PA-C pose with the WSMA Patient Safety Award plaque.
