Twin Cities Medical Society

Advance care planning is not merely the completion of a health care directive document or living will.  Instead, it is about conversations... ideally, conversations with a trained facilitator who can engage patients in discussions with their loved ones about their desires and values related to health care.  The result of conversations is often the completion of a health care directive.  

Twin Cities Medical Society, a physician association, is serving as the convener and coordinator of the initiative, utilizing its unique access to health care organizations and medical professionals in the Twin Cities metropolitan area.  So far, this effort has been a truly remarkable example of how interested parties can work together to provide better medical care for the patients of Minnesota.


Background

In 2008, the medical society convened two exploratory meetings—one with community members, the other with senior leaders from hospital systems and health plans -- to gauge the interest level in collaborating and coordinating advance care planning resources.  Community members wholeheartedly agreed that there was a need for such a model.  Soon after, senior leaders from hospitals and health systems gave their unanimous support to 1) not compete; 2) provide resources to support the initiative, and 3) to advocate internally within their respective organizations to advance the initiative.  With that feedback, the medical society formed an advisory committee and began to set the framework for the community collaborative.  In 2009, under the auspices of the advisory committee, a name and logo were chosen, standardized forms and patient education materials were chosen and a schedule of educational events for the community were set.  The nationally-recognized model, Respecting Choices, is being adapted using local governance and a directive form specific to Minnesota.  The directive was created together by all of the major systems and is available for free for anyone to use.


Health care organizations attend training and pilot HCM

Organizational commitment to the Honoring Choices Minnesota (HCM) initiative was obtained early on by a number of systems in the metro area.  Leaders from those health care organizations attended a training course to equip them in preparing their organizations to serve as pilot sites.  Leaders had to chose a patient population for the program and identify staff to be trained.  Work flow plans and quality measures were defined and these components were critical to the success of the pilot sites and served as a critical role in assuring system readiness. 

Seven pilot sites operated during the first half of 2010.  A July 2010 wrap up conference was held for pilot sites to convene as a group and report back on their findings.  More training was held and five new pilots are currently running through June 2011.  

One critical aspect to the success of the effort has been the local experts who are leading advance care planning efforts within their respective organizations.  Key leaders from Allina Hospitals & Clinics and Park Nicollet are adapting the Respecting Choices model and have been involved from the onset with the work of Honoring Choices Minnesota.  They are serving on the advisory committee and are providing their wisdom and experiences to the pilot sites as they work to roll out their programs. 

Next steps

Honoring Choices Minnesota has been widely accepted throughout the health care community and we will continue to provide training and resources.  Funding received so far has allowed us to move ahead in public engagemen and in developing patient education materials for Minnesotans.  Our hope is for all of the Twin Cities, and eventually the state, to understand the importance of health care decision making and be familiar with HCM as a resource.

We continue to hear from additional organizations who are interested in pursuing this model within their system.  Five new pilot sites are running from January - June of 2011 and another Sharing the Experience Conference will be held in July.

Public engagement aspect with TPT and the Citizens League

A strong component to this effort is the engagement of various groups who fall outside of traditional health care systems, such as ethnic and religious communities.  HCM is excited to be partnering with Twin Cities Public Television (TPT) and the Citizens League to help all families think and talk about advance care planning.  Read more and watch videos and discussions on TPT's website at http://tpt.org/choices.

For additional information on this initiative, please contact Twin Cities Metro Medical Society at 612-362-3704 or email This e-mail address is being protected from spambots. You need JavaScript enabled to view it. .

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