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How to Talk to Your Patients about End-of-Life Care: A Conversation Ready Toolkit for Clinicians
This toolkit is intended to help clinicians address some of the challenges of engaging with patients and families in end-of-life care conversations over time, with the goal of providing respectful end-of-life care that is concordant with patients’ stated goals, values, and preferences.
Respecting End-of-Life Care Wishes
This article presents five core principles to guide providers and health care organizations in developing more reliable systems to receive, record, and ultimately respect patients’ wishes for end-of-life care.
WIHI: Who's Your Health Care Proxy?
April 6, 2017 | Situations may arise when we need a trusted person to communicate with doctors and nurses on our behalf. And, if facing care decisions near the end of life, a trusted health care proxy can play a crucial role in ensuring our wishes are respected.
WIHI: Medicare Reimbursement and Meaningful Conversations about End-of-Life Care
November 19, 2015 | This WIHI explores whether the new US Centers for Medicare & Medicaid Services payment options to reimburse practitioners for talking with Medicare recipients about end-of-life care preferences make advance care planning more likely to happen and encourage health professionals to gain the necessary skills for such discussions.
Healthy Shelby: A Triple Aim Improvement Story
This Triple Aim improvement story examines the work of the Healthy Shelby Initiative in Tennessee, a community pursuing a regional focus to improve population health by linking public health, hospitals, health care providers, social service providers, academic institutions, the faith community, local government, and funders to work together to tackle some of the county’s most critical health problems: infant mortality, chronic disease management, and end-of-life care.
"Conversation Ready": A Framework for Improving End-of-Life Care (Second Edition)
This white paper presents a framework built on five core principles to help health care organizations and clinicians develop reliable processes to engage patients in conversations about their wishes for end-of-life care, steward that information, and provide respectful end-of-life care that is concordant with patients’ stated goals, values, and preferences.
WIHI: When Everyone Knows Your Name: Identifying Patients with Complex Needs
January 29, 2015 | A relatively small percentage of the US population accounts for the largest share of health care costs. Everyone knows who we're talking about, right? Well, not exactly.
WIHI: End-of-Life Care and How Communities Can Become "Conversation Ready"
January 15, 2014 | What role can communities play in having conversations with loved ones about wishes for end-of-life care? It can help to have others in the community to turn to for ideas, resources, and support – especially if the “kitchen table” conversation with important people in one’s life isn’t happening so readily.
What's Holding You Back from "Having the Conversation" About End-of-Life Care?
Ellen Goodman, co-founder of The Conversation Project, and Nathan Kottkamp, creator of National Healthcare Decisions Day, hosted a nationwide webinar to discuss the ongoing challenges Americans face when "having the conversation" about end-of-life care.
WIHI: Bright Spots for Patients with Complex Needs
March 27, 2014 | Interventions and initiatives to better support, care for, and partner with populations with costly and life-draining multiple illnesses and problems have grown in number and effectiveness. On this WIHI, we touch base with some of the people spearheading this work.
WIHI: Who’s Conversation Ready? How Health Care Can Respect End-of-Life Wishes
October 24, 2013 | This WIHI discusses two groundbreaking initiatives to reduce the confusion and improve the circumstances that surround end-of-life care for most Americans: The Conversation Project and Conversation Ready.
Reducing Cardiac Arrests in the Acute Admissions Unit: A Quality Improvement Journey
A quality improvement project in the acute admissions unit at the Stirling Royal Infirmary in Scotland achieved a 71 percent reduction in the number of cardiac arrests per 1,000 admissions; a 68 percent increase in referrals to palliative care per 1,000 admissions per month; and a 24 percent relative reduction in the 30-day mortality of patients admitted to unit. These results were achieved through the application of improvement methodology to test new innovations and promotion of a safety culture, among other changes.
Is Your Organization "Conversation Ready"?
Health care providers and organizations need to be “conversation ready” — that is, capable of asking about and understanding what matters most to patients, and respecting every individual’s end-of-life wishes. This article articulates emerging conversation-ready principles.
Engaging Patients and Their Loved Ones in the Ultimate Conversation
The Conversation Project, a grassroots public campaign, is encouraging conversations about end-of-life wishes and teaming up with the Institute for Healthcare Improvement, whose "Conversation Ready" initiative aims to help health systems and providers develop the skills to respect and carry out those end-of-life wishes.
WIHI: Conversations as Cornerstones of End-of-Life Wishes
August 30, 2012 | The Conversation Project is spreading stories, sharing tips and templates for getting started, and harnessing the power of social media to get people talking about their end-of-life wishes.
"Have You Had 'The Conversation'?": Ellen Goodman, IHI International Summit 2012 Keynote
In her keynote presentation at IHI's 13th Annual International Summit, Ellen Goodman shares her thoughts on The Conversation Project, which aims to create a cultural movement to normalize “the conversation” and to have every person’s end-of-life preferences expressed and respected.
WIHI: Have You Had "The Conversation"? Helping Loved Ones Discuss End-of-Life Preferences
January 26, 2012 | The Conversation Project seeks to create a cultural movement with one basic goal: to help every American say what they want at the end of life so that family members and medical providers have the guidance they need to respect those preferences.
Author in the Room: The Physician's Role in Patients' Nursing Home Care
November 2011 | A discussion with the author of the JAMA article "The Physician's Role in Patients' Nursing Home Care."
WIHI: Family Caregiving, Caregivers, and Compassion
October 5, 2011 | This WIHI discusses the need for providers to become more comfortable talking with patients and families about serious illness, more familiar with the benefits of palliative and end-of-life care, and more capable of appreciating the power of compassion.
WIHI: Palliative Care = Quality Care
April 21, 2011 | Three experts discuss palliative care as an integrated and integral part of the quality agenda, and talk about how to overcome real and perceived barriers using evidence, education, and small tests of change.
Author in the Room: Self-Care of Physicians Caring for Patients at the End of Life
April 2009 | A discussion with the author of the JAMA article "Self-Care of Physicians Caring for Patients at the End of Life."
When We're All Together, the Patient Knows It: Creating an Interdisciplinary Learning Community in Palliative Medicine
This paper describes a program at Lehigh Valley Health Network called Palliative Medicine Scholars (PalMS), which aims to incorporate palliative care through interdisciplinary learning.
WIHI: Quality Care During Advanced Illness: What Do Patients Want That Works?
October 8, 2009 | Between the care that patients and families want when faced with advanced illness, and what is often made available, “lies not just a gap but a chasm.” Patients and families often find themselves at odds with or abandoned by their medical providers at this stage of their care, forced to seek others who will respect their wishes.
How-to Guide: Improved Care for Patients with Congestive Heart Failure
The goal of this How-to Guide is to significantly improve care and reduce readmissions for patients with congestive heart failure by reliably implementing the recommended components of care.
Hard Choices for Loving People: CPR, Artificial Feeding, Comfort Measures Only and the Elderly Patient
This book helps people with life-threatening illnesses to make medical treatment decisions by reviewing the pros and cons of the different treatments.