The patient-centered approach at the heart of palliative care is dependent on a simple concept: knowing a patient’s values and wishes at any stage in life – even before a health crisis.
That’s the focus of advance care planning, a skill clinicians use to draw out essential whole-person information and translate it into goals of care.
It might sound easy, but it requires intention, training and practice, said Shirley Otis-Green, MSW, Clinical Director of Consulting Services for the Coalition for Compassionate Care of California, an advocacy group for quality end-of-life care.
“A lot of us do assume that we know what we need to know, and we can do it just fine, thank you very much. —Shirley Otis-Green, MSW
The Art of Asking, Listening
It all starts with a conversation.
“(Advance care planning) is so incredibly important,” Otis-Green said. It’s about learning “what patients value most, what their concerns are, what their fears are, and what gives meaning to their lives.”
She said many clinicians underestimate the skill required for such conversations.
“A lot of us assume that we ‘know what we need to know, and it’s all fine, so thank you very much’,” Otis-Green said. “But we know from lots of evidence … that those conversations are not always as in-depth and useful as (patients) would like them to be.”
Using What You’ve Learned
Worse, she said, there’s often a “mismatch” between what patients want and the care that’s ultimately delivered.
“People often get default care that they don’t need, want or benefit from, which costs our society lots of money,” Otis-Green said. “And it costs patients time lost from the things that matter most to them.”
What’s the solution?
Great training, such as the Advance Care Planning courses offered through the CSU Shiley Institute for Palliative Care, she said.
Building Skills Takes Training
“The Advance Care Planning curriculum at CSU is really wonderful,” said Otis-Green. “It gives (providers) the opportunity to take the experience they have – the good bedside skills and clinical expertise – and spend some time thinking about and explicitly exploring strategies for best practices related to end-of-life conversations.”
The Coalition for Compassionate Care of California helped create the content for the Advance Care Planning curriculum in partnership with the Institute.
Institute Courses Equip Clinicians for ACP
As part of that effort, a new course – Integrating Advance Care Planning into Your Medical Practice – has recently come online.
Otis-Green said the Institute’s Advance Care Planning courses explain how to “start those conversations earlier, so that all patients can have the care that’s tailored for them in the best possible way.”
“The people that have put together the curriculums here at CSU have done a tremendous job to look at evidence-informed approach and skill development,” Otis-Green said. “Being able to engage learners in perfecting the skills (needed) to have those kinds of meaningful conversations is so important.”
For more information on the Institute’s Advance Care Planning curriculum, click here or call 760-750-4006.