Greetings from Munich (Grusse aus Munchen)
The morning session was an opportunity to share advance care planning (ACP) success stories from different countries – Singapore (Living Matters), UK (Gold Standard Framework) and the US (Honoring Choices Wisconsin, Kaiser Permanente). Helen Mason from NZ also presented the findings of her Harkness Fellowship, identifying key components of health systems for successful ACP.
To me, the recurring themes were:
– the need for grassroots, community engagement
– identifying and using clinical and community champions of ACP
– the need for a coordinated whole systems approach
– not limiting ACP to end of life – focus on living well, not just dying, and
– employing continuous quality improvement.
Afternoon plenaries focussed on the health economics of ACP, with Josie Dixon of the London School of Economics, Claire Henry of Dying Matters & Bud Hammes of Respecting Choices. Take home messages? ACP is a complex intervention with complex outcomes and difficult to study and measure. It’s difficult to define “value”. And above all, the primary reason for ACP to improve care, not to save money.
There were also two sets of breakout sessions though out the day, with themes like Nursing Homes and Communication Interventions. It’s a tough job choosing which sessions to attend.
Stay tuned for Day 3 tomorrow!