Guest Blog by Heidi Meyers, R.N., M.B.A. – Start Somewhere: Fairview is Serious About Advance Care Planning

At Fairview, we understand that having a successful advance care planning (ACP) program system-wide is not a project, but an important program requiring full-time attention. I am very fortunate to have three staff members who serve as ACP liaisons to patients and staff, as well as a system committee, including Fairview, Ebenezer, MHealth, and Fairview Physicians Associates leaders who have been working for more than a year on end-of-life initiatives for our organization. Our clinicians face many competing priorities, so it is important for us to make it as easy as possible for them to understand and honor people’s wishes.

We began with Respecting Choices®, an evidence-based model of ACP discussions focused on the goals and values of individuals. Currently, over 850 staff and community members have completed our ACP training program, equipped now to serve as role models, teachers, and facilitators at Fairview, throughout local communities, and across the state. In the past year, we had four clinicians receive training the the “Communication in Serious Illness” program, a new research-based approach to improving conversations about values and priorities for people with serious illness. We have begun implementing this model across our system and anticipate more, better and earlier conversations with our patients, as well as improved care in alignment with their goals and values.

I am always happy to see initiatives like the Minnesota Health Action Group’s Advance Care Planning Call to Action. It’s another way we can all work together to ensure that discussions about final wishes are taking place — and that those wishes are honored. Engaging health systems, media, government, clinicians, employers and communities brings advance care planning into focus for everyone — not simply as a service we offer to those we serve, but also as something important for ourselves.

There is still much work to be done. Electronic medical records (EMRs) are improving, but not all fully support centralized access to health care directives. There is also a lack of consistency in how we begin and sustain discussions about this sensitive topic, and a lack of awareness of the importance of ACP for all adults, not just for those who are elderly or have a terminal illness. Still, I am encouraged by the high level of interest in our program, and the progress we are making in improving our EMR to provide a centralized, accessible hub for advance care planning documents and information.

Processes are now in place at all of our sites to ensure we are asking about ACP documents, providing resource materials, encouraging discussions with trained facilitators, and offering free classes on ACP that include help with creating documents. We look forward to the day when patients expect these conversations, rather than reacting with fear that “there’s something you haven’t told me!” Surprisingly, even people who are passionate about this topic don’t have a health care directive themselves. We tell everyone, start somewhere, but start. It’s crucial to know patients’ wishes so they can be honored.

Whether you want to sign up for one of our ACP classes, complete a health care directive for yourself, educate yourself or others about ACP, or learn more about Fairview’s work in this area, please visit our website. We even have resources available in many languages!

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