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Too often in our health care system, patients do not receive the care they wish for as they approach their last days or in medical emergencies. Starting a conversation about these situations can be difficult, whether we are physicians, patients, family members, religious and community leaders or health care providers. It is, however, imperative that these conversations happen. And once they occur, it is equally critical that individuals’ choices are known and honored by those who care for them.
Honoring Choices Wisconsin (HCW) is an initiative of the Wisconsin Medical Society (Society) to build system change, advocacy and education around advance care planning. Through HCW, the Society is serving as convener, coordinator and catalyst to make advance care planning a routine and standard part of care across Wisconsin.
Clinical training and guidance: HCW trains participating health care organizations to build strong advance care planning systems. More than just training facilitators, HCW assists organizations to ensure that conversations are offered routinely, scheduled, conducted, documented and entered consistently in the medical record. Participants begin with a small-scale, six-month trial implementation, and use the lessons learned to expand across the organization. The concepts, methodologies, training systems and materials are those of the Respecting Choices® First Steps® model. Respecting Choices is a pioneering program in advance care planning based in La Crosse. Honoring Choices Wisconsin faculty, certified through Respecting Choices®, provide training and consultation from the first days of implementation through sustainability.
Collaboration in the Health Care System: By agreeing to collaborate and not compete around this model, clinical sites and communities enjoy greater benefits and avoid duplicating work to improve advance care planning. As convener, the Society provides a platform for teams and stakeholders to share lessons and information, address challenges and share successes. The Society disseminates program materials, templates for action, and shared knowledge in person, through regular conference calls, an annual conference and on its website.
Physician Engagement: Physicians are essential to effective advance care planning. Their trusted encouragement normalizes these difficult conversations, and their leadership is required for success in the health care setting. As the voice of medicine in Wisconsin, the Society works closely with physicians and provides them tools, along with continuing medical education, to successfully engage their patients in advance care planning.
Common language, documentation and patient materials: The language around advance care planning is often confusing and undefined. HCW’s Glossary is contributing to the standardization of the vocabulary across Wisconsin. HCW participants use a common advance directive and patient education materials, providing standard messaging on advance care planning.
Measuring Success: HCW routinely collects data on the number of conversations offered, scheduled and conducted by its participants. We also measure patient and agent satisfaction with conversations and facilitator competence and confidence. In the long term, we expect significant changes in the number of Wisconsinites with advance care plans and documents, greater adherence to patient wishes in medical crises and at end of life, and greater satisfaction among patients and their families as they navigate these difficult situations.
How Your Organization Can Participate
Honoring Choices Wisconsin welcomes new participants year-round. We ask organizations to agree to a shared approach to advance care planning; commit to the training program and implementation of advance care planning as a routine part of care; agree to collaborate fully with other organizations; and contribute financially to the program.
The Wisconsin Medical Society commits to:
- Advocating for advance care planning as a process of understanding, reflecting on and discussing future medical decisions, including end-of-life preferences.
- Serving as convener, coordinator, and catalyst to make advance care planning a routine and standard part of care across the state.
- Providing education and support and a forum in which to share information.
Please consider participation and contribution to this important initiative. With your help, we can improve advance care planning for patients, families, friends, providers and communities across Wisconsin. For more information, e-mail Monica Messina at firstname.lastname@example.org.
The name “Honoring Choices Wisconsin” is used under license from the Twin Cities Medical Society Foundation.
RESPECTING CHOICES® is a registered mark used under license from Gundersen Lutheran Medical Foundation, Inc.