1. The Road Ahead for Serious Illness Care in (Your region)
DATE
© 2016 COALITION FOR COMPASSIONATE CARE OF CALIFORNIA

2. Welcome! HOST NAME Title & affiliation
© 2015 COALITION FOR COMPASSIONATE CARE OF CALIFORNIA

3. Image from FSG/Collective Impact Forum
Purpose
To build on the accomplishments of the 2016 statewide convening & move into local-level strategy that is specific & action-focused
Why we’re here today:
“Transformation is a process, not an event.” – John Kotter
Tremendous progress has been made at the national, state, and local levels. However, transforming the culture of care requires a coordinated, sustained effort over time.
We must continuously evaluate our progress, identify priority focus areas, and work in tandem to achieve our shared vision. Today we are going to build on the accomplishments of more than seventy leaders from around California who convened in Sacramento in 2016 for “The Road Ahead” – a daylong conversation hosted by the Coalition for Compassionate Care of California (CCCC) and the California Health Care Foundation (CHCF) on the topic of serious illness care in California.
Image from FSG/Collective Impact Forum
© 2015 COALITION FOR COMPASSIONATE CARE OF CALIFORNIA

4. Goals
Assess progress, gaps, and opportunities in serious illness care in our community
Strengthen relationships and collaboration
Create a shared vision for the future
Define and prioritize next steps for local action
© 2015 COALITION FOR COMPASSIONATE CARE OF CALIFORNIA

5. Introductions Please share: Your name Your organization Your role
One thing you’d like to leave with
© 2015 COALITION FOR COMPASSIONATE CARE OF CALIFORNIA

6. The Road We’ve Been On
The view from the state level: California’s progress, gaps & opportunities regarding care for people with serious illness
The day is structured around reviewing the information and thinking what was shared at the state meeting and then bringing our focus down to the local level, recreating that same process of generative thinking and dialog from the multiple perspectives we bring to the work.
© 2015 COALITION FOR COMPASSIONATE CARE OF CALIFORNIA

7. Professional Education & Development
The Road We’ve Been On- California
Overview of the Dying in California report
Based on the IOM Dying in America Report
Highlights progress, gaps & opportunities for improving serious illness care in CA
Professional Education & Development
The Dying in California report helps set context for our discussion. It was based off the seminal report from the IOM on Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life.
It highlights progress, gaps and opportunities for improving serious illness care in California.
© 2015 COALITION FOR COMPASSIONATE CARE OF CALIFORNIA

8. Professional Education & Development
The Road We’ve Been On- California
Overview of the Dying in California report
Overall findings:
Advance care planning and palliative care are not yet an integral part of the standard of care in California.
Growing demand for palliative care far outstrips capacity
A diverse group of stakeholders are joining together to support policy reform, outreach, and education around quality palliative care, serving patients earlier than tradition EOL care services
Professional Education & Development
Overall findings: (listed on PPT slide)
ACP and palliative care are not yet an integral part of the standard of care in California.
Growing demand for palliative care far outstrips capacity
A diverse group of stakeholders are joining together to support policy reform, outreach and education around quality palliative care, serving patients earlier than tradition EOL care services
© 2015 COALITION FOR COMPASSIONATE CARE OF CALIFORNIA

9. The Road We’ve Been On- California
5 central focus areas:
Delivery of Care
Clinician/
Patient Communication & ACP
Professional Education & Development
Public Education & Engagement
Policies & Payment Systems
Specific findings are organized into the 5 recommendation areas from the IOM report: (listed on PPT slide)
Delivery of Care
Clinician-Patient Communication and Advance Care Planning
Professional Education and Development
Policies and Payment Systems
Public Education and Engagement
For the “The Road Ahead” meetings, CCCC worked with a graphic artist to create visual depictions of the findings from the Dying in California report. We created four posters (or handouts) that you will see around the room today. (Policy & Payment Systems with the four other recommendation areas since they are interwoven in practice.)
© 2015 COALITION FOR COMPASSIONATE CARE OF CALIFORNIA

10. Grounding: The Road We’ve Been On
DELIVERY OF CARE
Primary goal: Increase access to comprehensive, high-quality palliative care services
(Follow the poster to name some examples of progress at the national and state level)
Today we are going to look at local Progress, Gaps & Opportunities.
© 2016 COALITION FOR COMPASSIONATE CARE OF CALIFORNIA

11. Grounding: The Road We’ve Been On
CLINICIAN-PATIENT COMMUNICATION
Primary goal: Develop and adopt standards for communication and ACP that are measurable, actionable, and evidence-based – and monitor performance
(Follow the poster to name some examples of progress at the national and state level)
Today we are going to look at local Progress, Gaps & Opportunities.
© 2016 COALITION FOR COMPASSIONATE CARE OF CALIFORNIA

12. Today we are going to look at local Progress, Gaps & Opportunities.
Grounding: The Road We’ve Been On
PROFESSIONAL EDUCATION & DEVELOPMENT
Primary goal: Strengthen palliative care knowledge and skills of all clinicians who care for people with advanced illness
(Follow the poster to name some examples of progress at the national and state level)
Today we are going to look at local Progress, Gaps & Opportunities.
© 2016 COALITION FOR COMPASSIONATE CARE OF CALIFORNIA

13. Today we are going to look at local Progress, Gaps & Opportunities.
Grounding: The Road We’ve Been On
PUBLIC EDUCATION AND ENGAGEMENT
Primary goal: Engage and empower public to make informed healthcare decisions based on individual needs and values
(Follow the poster to name some examples of progress at the national and state level)
Today we are going to look at local Progress, Gaps & Opportunities.
© 2016 COALITION FOR COMPASSIONATE CARE OF CALIFORNIA

14. The Road We’ve Been On - Let’s Get Local
Local achievements– small groups (20 min.)
What are some of our most important strengths & accomplishments in each area?
Delivery of Care
Clinician-Patient Communication
Professional Education & Development
Public Education & Engagement
Now we will take a little time to capture and acknowledge progress we’ve made at the local level
Make sure there is a designated scribe (or have a facilitator at each table)
Go around your table and each take a few minutes to share what they think are some of the most important local strengths and accomplishments in any of the above four topic areas.
© 2015 COALITION FOR COMPASSIONATE CARE OF CALIFORNIA

15. The Road We’ve Been On - Let’s Get Local
Share accomplishments with full group. THANK YOU! Together we are building the future of living well with serious illness in our community.
Have each group report back to full group after 20 minutes of discussion.
Take another 15 minutes to capture accomplishments from all groups on a central flip chart visible to the full group
We want to acknowledge that this work is hard, we have a long road ahead to achieve the goals we are striving for. However, it is also essential that we recognize and celebrate all the progress that has been made along the way. Let’s celebrate the important contributions that all of you in this room have been making to improve the experience of serious illness in our community.
© 2015 COALITION FOR COMPASSIONATE CARE OF CALIFORNIA

16. Visioning The Road Ahead A shared vision for the future
© 2015 COALITION FOR COMPASSIONATE CARE OF CALIFORNIA

17. CCCC’s 10-Year Vision for California
To transform health care in California so that medical care is aligned with individual patients’ preferences: People get the care they need and no less & the care they want and no more
CCCC has done some excellent work in articulating a very clear 10-year vision for serious illness/ end-of-life care in California. We are fortunate to be in a state where this kind of vision is in place to guide and inspire our work.
© 2015 COALITION FOR COMPASSIONATE CARE OF CALIFORNIA

18. The Road Ahead Vision for California
In 10 Years….
The demand for high-quality care for serious illness will be widespread
Individuals and communities will engage in conversations about care for serious illness as a normal activity where people live, learn, work, play and pray.
© 2015 COALITION FOR COMPASSIONATE CARE OF CALIFORNIA

19. The Road Ahead Vision for California
In 10 Years….
Healthcare professionals will be competent and comfortable talking with patients about goals of care and treatment preferences, and will skillfully guide them to receive the care they need and want.
© 2015 COALITION FOR COMPASSIONATE CARE OF CALIFORNIA

20. The Road Ahead Vision for California
In 10 Years….
Healthcare organizations will increase access to palliative care, make advance care planning conversations a consistent part of care, and ensure that patient wishes are honored at the end of life.
© 2015 COALITION FOR COMPASSIONATE CARE OF CALIFORNIA

21. The Road Ahead Vision for California
In 10 Years….
Public policy and provider reimbursement will support these conversations
Documentation of preferences will be shared across the care continuum
© 2015 COALITION FOR COMPASSIONATE CARE OF CALIFORNIA

22. The Road Ahead Vision for California
How do we get there…?
Work collectively at every level to:
Increase demand for patient-centered palliative care and end-of-life care through public education and engagement, and patient empowerment.
Increase supply of healthcare professionals and organizations prepared to support individuals and families throughout the course of their lives and illnesses.
Increase capacity of the California network to improve serious illness care.
© 2015 COALITION FOR COMPASSIONATE CARE OF CALIFORNIA

23. CCCC’s 10-Year Vision for California
This graphic captures these four key components of achieving this vision and how they all work together. We at the local level are part of the crucial level of “CALIFORNIA PARTNERS” where so much of the real work happens.
Our work today helps:
strengthen this larger vision for California as a whole
strengthen our local efforts as an important part of the statewide network and
connect us more directly to the state coalition and its expertise and resources
© 2016 COALITION FOR COMPASSIONATE CARE OF CALIFORNIA

24. What is our local version of this vision?
The Road Ahead Vision- Let’s Get Local
Small group discussion (15 min.)
What is our local version of this vision?
Small group discussion (at tables or in breakout groups of 4-5).
What is our local version of this vision? What would you change or add to make these points as relevant as possible to our local needs and goals?
Make sure there is a designated scribe or have a facilitator at each table
Have each group report back to full group after 15 minutes of discussion.
Take another 10 minutes to have a note-taker capture comments from all groups on a central flip chart visible to the full group.
© 2015 COALITION FOR COMPASSIONATE CARE OF CALIFORNIA

25. BREAK
15 minutes
© 2015 COALITION FOR COMPASSIONATE CARE OF CALIFORNIA

26. ASSESSING & ACTIVATING
Goal: Identify needs, opportunities, and promising action steps
Now, we are moving into the part of the day where we roll our sleeves up. We’ll assess local needs and opportunities around improving serious illness care and begin looking at promising action steps.
© 2015 COALITION FOR COMPASSIONATE CARE OF CALIFORNIA

27. Assessing & Activating
Small Group Discussion
Assessing- Using the “Assessing Needs & Opportunities” tool, discuss where the greatest gaps are in our local serious illness care network.
Prioritizing – Choose your top 4. What should we do first in order to have the biggest impact?
Taking Action– What action can we take now to address this need?
The Road Ahead gathering in Sacramento resulted in a compilation of ideas and recommendations for furthering progress in each of the four topic areas:
Topic 1: Delivery of Care
Topic 2: Clinician-Patient Communication & ACP
Topic 3: Professional Education & Development
Topic 4: Public Education & Engagement
We are going to use these ideas as a jumping-off point for assessing local needs and opportunities and moving into action steps. You will all now have a chance to participate in small group discussions of two out of the four topic areas, focusing on greatest opportunities for progress and action.
There will be two, 30-minute facilitated “discussion circles.”
Pick the two topic areas of highest interest/relevance to your work. You’ll spend 30 minutes at one topic table and then rotate at the 30-minute mark to the second area of your choice.
© 2015 COALITION FOR COMPASSIONATE CARE OF CALIFORNIA

28. Assessing & Activating
Two 30-minute “discussion circles”
1st rotation = 00:00-00:00
2nd rotation = 00:00-0:00
Choose two topics that are of highest interest/ relevance to your work:
Topic 1: Delivery of Care
Topic 2: Clinician-Patient Communication & ACP
Topic 3: Professional Education & Development
Topic 4: Public Education & Engagement
© 2015 COALITION FOR COMPASSIONATE CARE OF CALIFORNIA

29. Assessing & Activating
Needs, opportunities, & action steps: Share with the full group
Facilitators from each of the four topic areas will share the top needs/opportunities and action steps, combining input from both rounds.
© 2015 COALITION FOR COMPASSIONATE CARE OF CALIFORNIA

30. BREAK
10 minutes
© 2015 COALITION FOR COMPASSIONATE CARE OF CALIFORNIA

31. Assessing & Activating
Implementation:
Stepping up for taking action
Here is where the rubber meets the road.
Let’s go through each of these areas and see if there are participants who want to take the lead in coordinating an implementation process for specific areas of action.
© 2015 COALITION FOR COMPASSIONATE CARE OF CALIFORNIA

32. Building the Movement …it matters! Collaboration and Collective Impact
© 2015 COALITION FOR COMPASSIONATE CARE OF CALIFORNIA

33. Wrap up
Please complete your evaluation. Thank you for all that you do – we’ll be in touch!
© 2015 COALITION FOR COMPASSIONATE CARE OF CALIFORNIA