Transcript /~tony/courses/502/FG%20Report.ppt

End of Life Planning
Project
Region Nine Community Care
Partnership
Final Report
End of Life Planning Project—Final Report
“Compassionate and competent care
will be available, understandable,
and accessible to all who are at the
end of life. The diversity of cultural,
spiritual, and religious beliefs will be
treated with respect and sensitivity.”
MN State Commission on End of Life Care
Current Reality
2001
Deaths
U.S.
Rural
MN
Region
Nine
Hospital LongDeaths term
Care
53%
24%
37.5%
37%
Death
at
Home
23%
18%
27-48% 32-54% 11-26%
Received
Hospice
Care
20%
16%
4-24%
Assumptions
1.
2.
3.
4.
5.
6.
7.
End of Life Care can be done in a gentler, more
respectful manner and cost less.
Futile high tech interventions are implemented
when less costly, highly personalized
interventions might better meet the needs of
patients and families.
Patients and families can be better prepared for
the types and difficulty of decisions needed.
Patient comfort can be improved.
Health care costs will continue to escalate as the
population ages and eventually palliative care
versus cure will be emphasized.
There are differences between hospice and endof-life care.
Providers are doing the best the can within the
current system.
Objectives
1.
To conduct a comprehensive needs assessment
in the region determining the care needs of end
of life and deteriorating chronically ill persons.
2.
To create a regional strategic plan for respectful
care for people in end stage chronic disease
and through the dying process.
3.
To determine respectful strategies to decrease
pain and suffering of people in end stage
chronic disease.
4.
To assist patients and families to make timely
choices during deteriorating chronic illness.
Methodology
 Regional
advisory committee to
guide the process
 22
Focus groups
 Interviews
with patients & physicians
 Interviews
with payers and policy
makers
Focus Groups
Urban & Rural
 Hospital nurses
 Clergy
 Home Care
Workers
 Family
 Hospice Staff
 Long Term Care
Administrators

Long Term Care
Staff/Aides
 Senior Citizen
Volunteers
 Social Workers
 Assisted Living
providers
 Latinos

Data Analysis
 Content
Analysis of transcripts
 Advisory
Committee analysis &
expansion
 Steering
team analysis
Findings
1.
Better access to a variety of resources
for patients, caregivers, families.
2.
Education regarding end of life issues for
patients, families, professional
caregivers, and general public
3.
Improved communication among and
between family members and
professional caregivers
Findings (cont.)
4.
Smooth transition among various
stages along continuum of care
5.
Earlier admission to hospice &
system of palliative care leading up
to hospice
Other Findings
 Payers
& policy makers mirrored
other focus groups
 Rural
differences in resources &
relations
 Cultural
differences—end of life far
from home
 Importance
of education
Recommendations
Expected Outcome: Creation of a
health care system that is


Patient directed
Consumers are educated to
direct their care
Recommendations (cont.)
Goal 1: Create a regional, culturally
sensitive care system for palliative and
end of life care
3-5 year demonstration project
 Increased palliative care options
 Reimburse integrated care coordination
 Culturally sensitive advanced care
planning
 Portable health records
 Promote hospice as a choice

Recommendations (cont.)
Goal 2: Develop and deliver education to
improve seamless palliative and end of life
care.
Stakeholders to develop end of life
education plan
 Culturally sensitive end of life curriculum
for multiple audiences
 Mass-market promotion for advance care
planning
 Mentors for family caregivers

Contact
Region Nine Development Commission
410 Jackson St.
Mankato MN 56002-3367
507-387-5643
www.rndc.org
Funded by a grant from the
Blue Cross Blue Shield of MN Foundation