Shared decision making is a key component of patient-centered care, defined by the Washington State Health Care Authority as “a process that allows patients and their providers to make health care decisions together, taking into account the best scientific evidence available, as well as the patient’s values and preferences.” Our goal is statewide movement toward greater use of shared decision making in clinical practice at a care delivery site and organizational level framed through four focus areas:
– A common understanding and shared definition of shared decision making and the benefit of shared decision making
– Ten priority areas as an initial focus for the health care community
– Highly reliable implementation using an existing framework customized to an individual organization
– Documentation, coding, and reimbursement structure to support broad use
People with serious or advanced illness often experience increases in symptoms coupled with a decrease in function. Traditional life-prolonging or curative care often does not meet a person’s range of needs as illness progresses. Our group developed the following focus areas to increase accessibility and quality of palliative care:
– Defining palliative care using the standard definition developed by the National Consensus Project including appropriateness of primary and specialty palliative care.
– Spreading awareness of palliative care.
– Clinical best practice provision of palliative that is:
* Responsive to local cultural needs,
* Includes advance care planning as outlined in the 2014 Bree Collaborative End-of-Life Care Report and Recommendations including appropriateness of an advance directive and Physician Orders for Life-Sustaining Treatment (POLST), and
* Incorporates goals of care conversations into the medical record and plan of care.
– Availability of palliative care through revision of benefit structure such as a per member per month (PMPM) benefit.
For more information or to give additional feedback, please contact Ginny Weir, Director of the Bree Collaborative at GWeir@qualityhealth.org or (206) 204-7377 or visit www.breecollaborative.org
Thank you for your participation in this effort to improve health care quality, outcomes, and affordability in Washington State.