Karen Reeves, BSN, MHHA, FACHE VP Risk Management and Accreditation South Carolina Hospital Association kreeves@scha.org 803.280.0527

and

South Carolina Healthcare Decisions Day

Na#onal  Healthcare  Decisions  Day  and  SC  Healthcare  Decisions  Day  (SCHDD)  

•  Purpose:  to  inspire,  educate/empower  the  public    providers  about  the  importance  of  advance  care  planning  

•  April  16  (death  and  taxes)  •  Tools  and  resources:  www.nhdd.org/tools  •  SCHDD  AcEon  Guide  and  resources  on  SCHA  website            hGp://www.scha.org/shared-­‐decision-­‐making;  provide  a  link  on  your  website  

•  First,  lead  by  example-­‐be  sure  you  have  thoughMully  considered  and  made  your  healthcare  decisions  known  

 

 

 SCHDD  Ac#on  Guide  

 •  Modify  the  tools,  and  add  your  logo  (keep  CSI  logo  on  also)  

•  Add  your  organizaEon  to  the  NHDD  website  and  host  an  educaEonal  event  

•  IdenEfy  a  point  person  (Physician,  nursing,  PR/MarkeEng/Community  Outreach,  Chaplain,  Ethics  CommiGee  representaEve)  

•  LeGers  to  Editor/op  eds,  press  releases  about  the  need  for  advance  direcEves  (template  available)  

   

 

SCHDD  Ac#on  Guide  

•  Set  up  SCHDD  exhibits  and  offer  informaEon  on  advance  direcEves  for  public  and  staff  – “Isn’t  It  Time  We  Talk?”  brochure  – FAQ  about  Advance  Health  Care  DirecEves  – Advance  DirecEves  (English  and  Spanish)  

•  Speak  at  civic  groups  about  the  need  for  advance  direcEves  

•  Incorporate  into  your  wellness  plan  (aGestaEon  that  employee  has  an  advance  direcEve)  

SCHA  Board  Ac#on  January  2015  1.  SCHA  member  faciliEes  will  publically  celebrate  NHDD/SCHDD  by  implemenEng  selected  acEviEes  outlined  in  the  SCHDD  AcEon  Guide  with  their  employees,  staff,  and  the  public,  2.  SCHA  will  seek  public  co-­‐endorsement  of  NHDD/SCHDD  with  the  South  Carolina  Medical  AssociaEon,  and  3.  SCHA’s  celebraEon  of  NHDD/SCHDD  will  include  reaching  out  to  our  partnering  organizaEons,  Personal  Membership  Groups,  agencies,  businesses,  and  the  public  to  urge  them  to  also  implement  the  SCHDD  AcEon  Guide.  

 Addi#onal  Resources  NHDD/SCHDD  

 •  The  ConversaEon  Project  hGp://theconversaEonproject.org/  

•  IHI’s  ConversaEon  Ready  iniEaEve    hGp://www.ihi.org/Engage/IniEaEves/ConversaEonProject/Pages/ConversaEonReady.aspx  

•  Being  Mortal:  Medicine  and  What  MaGers  in  the  End,  Atul  Gawande  

tgyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyy  

•     

SC  Coali#on  for  the  Care  of  the  

Seriously  Ill  (CSI)  Charter  Members

•  South  Carolina  Medical  AssociaEon    •  South  Carolina  Hospital  AssociaEon    •  South  Carolina  Nurses  AssociaEon  •  The  Carolinas  Center  for  Hospice  and  End  of  Life  Care    •  South  Carolina  Healthcare  Ethics  Network    •  South  Carolina  Society  of  Chaplains    •  LifePoint  •  AARP    

SC  Coali#on  for  the  Care  of  the  Seriously  Ill  (CSI)  Other  Par#cipants  

•  South  Carolina  Bar  •  Lt.  Governor’s  Office  on  Aging  •  EMS  •  SC  Healthcare  AssociaEon  •  Leading  Age  SC  •  SC  CiEzens  Concerned  for  Life  •  SC  DHEC  •  Various  volunteers  with  experEse  in  specific  areas  such            as  law,  social  work  and  legislaEon

SC  Coali#on  for  the  Care  of  the  Seriously  Ill  (CSI)  

Vision  Statement:  SC  delivers  excellent  communicaEon  and  shared  decision-­‐making  for  persons  with  serious,  chronic,  or  terminal  illnesses.      Mission  Statement:  All  persons  in  SC  with  serious,  chronic,  or  terminal  illnesses  will  have  an  acEve  voice  in  the  care  decision  process.  

Coali#on  for  the  Care  of  the  Seriously  Ill  (CSI)  POLST  Pilot  

Na#onal  POLST  Paradigm  (“Physician  Orders  for  Life  Sustaining  Treatment”)    • Shared  decision-­‐making  conversaEon  between  MD-­‐      paEent  re  EOL  care  for  persons  with  serious  illnesses  • PaEent  wishes  documented  in  POLST  form  which            translates  the  shared  decisions  into  acEonable      medical  orders      • POLST  is  appropriate  for  paEents  with  serious  illness      or  frailty;  MD  would  not  be  surprised  if  they  died        within  one  year  • POLST  =  standing  medical  order  for  current  tx;    • Advance  DirecEve  =  future  instrucEons/guidance    

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Coali#on  for  the  Care  of  the  Seriously  Ill  (CSI)  POLST  Pilot  

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Coali#on  for  the  Care  of  the  Seriously  Ill  (CSI)  POLST  Pilot  

•  POST:  “Physician  Order  for  Scope  of  Treatment”  •  DHEC  authoriza#on  for  pilots:  

– MUSC-­‐Roper  and  partners,  including  EMS  – Greenville  Hospital  System-­‐Bon  Secours  and  partners,  including  EMS  

•  Legisla#on  may  be  needed  ader  pilot  for  POST  to  be  ‘durable’ across  seengs    

•  Limita#ons  of  EMS  DNR  order    –  Terminal  condiEons  only  –  Rarely  used  – Medical  staff  bylaws  may  need  revision  

How  Advance  Direc#ves  and  POLST  Work  Together  

Adapted with permission from California POLST Education Program © January 2010 Coalition for Compassionate Care of California