Care New England Health System (the parent company of Butler, Kent and Women & Infants hospitals, the VNA of Care New England, and the Care New England Wellness Center) has joined with five other pioneering organizations to support a new effort by the Institute for Healthcare Improvement (IHI) to better prepare health care providers to receive and respect patients' wishes about end-of-life care. The initiative is a critical companion to The Conversation Project, which launched nationwide last month.
The Conversation Project, a public campaign co-founded by Pulitzer Prize-winner Ellen Goodman and developed in collaboration with IHI, is a public campaign with a simple and transformative goal: to have every person's end-of-life wishes expressed and respected. As a pioneer sponsor, Care New England has committed to being "conversation ready" within one year by developing and piloting processes and tools to encourage people to express their wishes and, in some instances, to break the silence between patient and provider. Pioneer sponsors will develop a change package that they will implement first in their own organizations and then will be shared throughout the industry.
"Care New England is committed to providing the best possible care for our patients throughout their lives and including the end of their lives. We have a strong commitment to our patients and their families, and we want to provide care that is consistent with a patient and family's wishes," said Kate M. Lally, MD, FACP, director of Palliative Care at Kent Hospital and Medical Director of the VNA of Care New England. "The Conversation Project is a national initiative to get all Americans talking about their wishes for care at the end of their lives. We all need to think about whether we want care focused on comfort at the end of our lives, or aggressive treatment as long as possible. Care New England wants to encourage people to have these conversations with their families. We also want to support our patients' decisions, whatever they may be. We are honored to be able to take part in such an important project to improve the lives of patients everywhere."
As people express their wishes, it's critical that health care systems have the people and processes to hear and respect what's being said. IHI calls this being "conversation ready" and will now work closely with up to 10 pioneer sponsor organizations as well as prominent end-of-life experts to package proven methods and programs with new tools and strategies to achieve this goal. At the very basic level, many health care organizations have nothing in place to prompt discussions with patients and families about health care directives or end-of-life wishes, or to record, access, and follow the instructions.
"Like many important issues in health care targeted for improvement," says Maureen Bisognano, IHI's president and CEO, "end-of-life care has often suffered from good intentions without enough good systems in place to change behaviors, attitudes, and practices. When families and loved ones have discussed their wishes and preferences ahead of time, they can engage with the medical community differently; doctors and nurses, in turn, have the opportunity to act in a supportive fashion, using their clinical knowledge to help patients experience a 'good death,' as opposed to a 'hard death' that so many people fear and have witnessed. IHI is proud to be working with The Conversation Project and the pioneering organizations that have joined us to achieve this cultural change."