“Our ultimate goal, after all, is not a good death, but a good life to the very end.” – Dr. Atul Gawande
For the past five years, Maryland’s hospitals have upended the traditional definition of what it means to be a hospital. You’ve brought proactive care to people’s neighborhoods, homes, and families. You’ve become not only a safety net for when people are injured or ill, but also a driving force to keep them healthy in the first place.
Keys to this change have been the partnerships you’ve forged with other providers – like physicians, nursing facilities and more. This week, we took an important step toward reaching another partner who will be critical as we continue to build a health care system for the 21st century: the people we serve.
On Wednesday, MHA hosted the Collaboration in Care Planning forum, bringing together nearly 150 hospital leaders, doctors, nurses, academics, students, and post-acute providers, to share promising strategies for changing the culture around end-of-life planning and conversations. The forum had its roots in a recommendation from MHA’s continuing care work group, which proffered that improving advance care planning would be beneficial to all people, whether or not they are being cared for in a health care facility.
A key goal of the effort is to address a gap between what patients and families want and what health care providers actually deliver. Consider that 70 percent of people want to die at home, yet in Maryland, 62 percent of deaths occur at a hospital, nursing home, or hospice.
We can do better.
We know that by asking for and respecting the wishes of the people we serve, patients and families will have a superior experience of care. We know from Wednesday’s forum that some of Maryland’s hospitals and communities are successfully executing strategies to increase advance care planning and the sharing of advance directives with those working at the point of care. These lessons tell us that for meaningful change to happen, leaders must embrace the issue, direct resources to improve the manner in which we engage people around end-of-life decisions, and follow through to ensure culture change is lasting and meaningful.
Fortunately, this is not a new problem. Similar to hand hygiene, it’s less about recognizing what must be done and more about how well improvement is executed. Soon, MHA will post a video of Wednesday’s forum and links to key resources. Please draw upon these tools and consider how your hospital or health system can improve.
Changing the culture around advance care planning is no small feat, but I am encouraged by the fact that this is a goal that all health care providers support. That’s a pretty good place to start for something so important.