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Honoring Choices Wisconsin

Frequently Asked Questions

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Answers to frequently asked questions are below.

 

What is Honoring Choices Wisconsin?

Honoring Choices Wisconsin (HCW) is a major initiative of the Wisconsin Medical Society (Society). Its mission is to promote the benefits of and improve processes for advance care planning across the state, in health care settings and in the community.

Modeled after Honoring Choices Minnesota, a project of the Twin Cities Medical Society, and based on Respecting Choices® First Steps®, a pioneering program in advance care planning in La Crosse, the Society serves as a convener, coordinator and catalyst to redesign health care organization’s advance care planning systems by utilizing proven concepts, methodologies, training systems and materials.

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Why is it important?

Starting a conversation about care in times of medical crisis is difficult for many of us, whether we are physicians, patients, family members, religious and community leaders or other health care professionals. It is, however, imperative that these conversations happen. And once they occur, it is equally critical that individuals’ choices are honored by those who care for them.

What is advance care planning?

Advance care planning is a process across time of understanding, reflecting on and discussing future medical decisions, including end-of-life preferences. Advance care planning includes:

  • Understanding your health care treatment options.
  • Clarifying your values and beliefs as they relate to your health care goals.
  • Weighing your options about what kind of care and treatment you would want or not want.
  • Making decisions about whether you want to appoint a health care agent and/or complete an advance directive.
  • Communicating your wishes and sharing any documents with your family, friends, faith leaders, other advisors, and physicians and other health care professionals.

 

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Why is the Society interested in advance care planning?

Wisconsin has been a champion for advance care planning, hospice and palliative care for years. The Society’s Council on Ethics recognized, however, that advance care planning still is not the norm for physicians, individuals and their families, and looked for ways to meet the enormous need for improvement. After viewing the documentary Consider the Conversation and learning of the Honoring Choices Minnesota model, the Council and the Society’s Board of Directors agreed such an effort is crucial to the health of the people of Wisconsin. In 2012, the House of Delegates formalized its support for the Society to take a lead role in the development and implementation of a statewide advance care planning initiative.

What is the Society asking health care systems to do?

The Society is building collaboration around facilitating advance care planning conversations and honoring individuals’ decisions throughout care. To participate in the initiative, health care organizations agree to:

  • Emphasize improving the conversation across health care systems and communities throughout Wisconsin.
  • Utilize a common advance directive document and other informational materials.
  • Train staff in the Respecting Choices® First Steps® approach.
  • Devote organizational resources to this work.
  • Share lessons learned from their experiences formally and informally.
  • Capture consistent quality measures.
  • Contribute financially to the Honoring Choices Wisconsin initiative.

 

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What are the anticipated outcomes of HCW?

We believe this coordinated effort around advance care planning will result in:

  • Improved understanding of advance care planning, hospice and palliative care among physicians, other health care professionals and individuals.
  • Higher completion rates of advance directive documents. End-of-life care that follows an individual’s wishes.
  • Fewer hospital readmissions and t intensive care unit days and increased hospice utilization.
  • Less complicated grief among family members after the death of a loved one.
  • Greater public awareness of and demand for advance care planning.

 

What is the Society’s role in this initiative?

The Society serves as convener, coordinator and catalyst for Honoring Choices Wisconsin. To facilitate this approach, the Society:

  • Engages physicians on the importance of advance care planning.
  • Delivers design and implementation workshops, facilitator and instructor certification courses following the Respecting Choices First Steps curriculum.
  • Assists health care organizations in designing and implementing a sustainable advance care planning system.
  • Provides a forum for information and resource sharing.
  • Publicizes the work of the Honoring Choices Wisconsin participating organizations.

 

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How can we measure success?

In the short term, we can measure the number of individuals offered facilitated conversations through the initiative, the number of conversations conducted and the number of new advance directives completed and entered into the medical record. Over the long term, we can track increases in the number of conversations and advance directives completed across the health care system, the number of days patients spend in the hospital, intensive care unit and hospice in their last days of life, and satisfaction and depression rates among family members after the death of a loved one.

Since its launch in 2012, more than 6,000 patients have engaged in conversations about their future medical decisions, including end-of-life preferences, with HCW-trained facilitators. Currently, there are 31 health care organizations statewide participating in Honoring Choices, and that number is expected to increase in 2016.

Does this project require legislation?

No. Although many agree there is room for improvement in Wisconsin’s advance care planning statutes, we believe that the state’s health care systems can make dramatic improvements to advance care planning without a need for new legislation or government intervention.

Does this program include POLST?

No. The POLST (Physician Orders for Life-Sustaining Treatment) form is a physician order that documents individuals’ goals of care as they approach their last days. The Honoring Choices Wisconsin initiative focuses on the “upstream” advance care planning conversations that all competent adults should have.

Please contact Honoring Choices Wisconsin at hcw@wismed.org to learn more about what you and your organization can do to participate.

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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.