1. Honoring Choices at Ridgeview Medical Center Sue DeGolier July 19, 2012

2. About Ridgeview Medical Center

3. Distinguishing Features of Our Program  Established a dedicated Honoring Choices referral phone line  Hand chosen volunteer facilitators do an outstanding job  Model is financially sustainable and has capacity for growth  Comfort and convenience of the home setting for facilitation sessions is well received

4. Program Milestones  Pilot conducted January through June 2011  POLST form implemented in organization  Currently 14 RMC volunteers have completed facilitator training  Referral process for facilitations rolled out to all Ridgeview Clinics April 1, 2012  Several presentations have been done in the community to create awareness about Advance Care Planning  Soft roll-out regarding availability of facilitations for hospital and home care patients communicated to RMC social workers, July, 2012

5. Referrals Rolled out to Ridgeview Clinics on 4-1-12

6. Contact Results and Outcomes

7. Measurement of ACPs in EMR

8. Total Expirations = 29 Total Expirations with EMR = 13

9. Other Things We Measure

13. Honoring Choices Referrals Post Advance Care Planning Discussion Survey Results Client Satisfaction Surveys given/received Data: Level of satisfaction is rated 1(not at all) to 5 (very much) 1.) I feel that this discussion was helpful to me.100% = 5 (very much) 2.) I feel better prepared to make decisions about my future health care. 100% = 5 (very much) 3.) I feel the facilitator did a good job of helping me with my needs for advance care planning. 100% = 5 (very much) Surveys given = 12 Surveys Returned = 7 Total number of referrals eligible for survey

14. Challenges  Monitoring resources and demand to assure enough facilitators and that volunteers are as busy as they want to be with facilitations  Cases may be open for a period of time  Some patients decline; need to develop a process for notifying referral source  We’ve received a limited number of survey responses  Not clear if ACP in record is a result of Honoring Choices  Variability in the level of engagement among Primary Care Providers

15. Next Steps  Develop measurement for staff time per referral (to contact facilitator, follow up on paperwork, etc.)  Develop a process for notifying referral source if patient declines  Develop plan for contacting people who have indicated they have an ACP, but copy is not in the medical record. Offer to review ACP with them or to do a facilitation; get copy into the medical record  To increase number of ACPs in the medical records at the clinic and the hospital will change the process to have facilitators bring original ACP to our office. We will make copies and mail/route  Since number of returned surveys is low, plan to change the process to have facilitators ask the client to fill out the survey and seal it in an envelope and hand it to the facilitator

16. Questions?