Is Advance Care Planning worth advancing?

This free webinar from the International Collaborative for Best Care for the Dying Person features insights from leading international practitioners in end of life care on the future of Advance Care Planning.   

PROGRAMME

Following the Science: The lessons of Advance Care Planning

Professor R. Sean Morrison, MD

Advance care planning (ACP) emerged over the last thirty years as a potential response  to the problem of low value end-of-life care.  The assumption that ACP will result in goal concordant end-of-life care led to wide-spread public initiatives promoting its use, physician reimbursement for ACP discussions, and use as a quality measure.  However, the scientific data do not support this assumption.  Over the last twenty-five years, studies have evaluated ACP using various methods and across large groups of patients.  Despite the intrinsic logic of ACP, the evidence suggests ACP does not does not improve end-of-life care or enhance goal-concordant care.  Its documentation does not serve as a reliable and valid quality indicator of an end-of-life discussion.  In his talk, Dr Morrison will review the science of ACP, discuss the gap between the ACP and the decision-making process in actual clinical practice settings, and outline alternatives to ACP.

Shifting to Serious Illness Communication

Associate Professor Juliet Jacobsen MD

Although the research evidence for advance care planning has been debated, it is clear that patients with serious illness and their loved ones experience distress that can be lessened or even prevented through skilled communication.  In this talk, Dr Jacobsen will discuss how skilled communication can be promoted through an emerging construct and structured intervention, serious illness communication.  She will outline how this four-step patient centered approach can be used for a wide range of conversations that include the diagnosis, prognosis, and even acute medical decision making at the end of life. Dr Jacobsen will also detail one hospital’s experience implementing a systems-based approach to serious illness communication, and highlight the important role of champions and analytics in the promotion of communication culture change.

Questions and Answers

Moderated by Professor John Ellershaw

Questions can be submitted in advance via email to admin@bestcareforthedying.org or by using the Chat function during the webinar. 

SPEAKERS

Professor R. Sean Morrison, MD

Ellen and Howard C. Katz Professor and Chair, Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai.  Director, National Palliative Care Research Center

Dr. R. Sean Morrison is the Ellen and Howard C. Katz Professor and Chair of the Brookdale Department of Geriatrics and Palliative Medicine. He is also Co-Director of the Patty and Jay Baker National Palliative Care Center and Director of the National Palliative Care Research Center, national organizations devoted to increasing the evidence base of palliative care in the United States.  Dr. Morrison is the recipient of numerous awards, including the American Academy of Hospice and Palliative Medicine’s PDIA National Leadership, Excellence in Research, and Visionary Awards; the American Cancer Society’s Distinguished Achievement in Cancer and Clinical Research Professor Awards; the American Geriatrics Society’s Outstanding Achievement for Clinical Investigation Award; and the Jacobi Medallion (Mount Sinai’s highest recognition).  His work has appeared in major peer-reviewed medical and policy journals, including the New England Journal of Medicine, Health Affairs, and the Journal of the American Medical Association. He edited the first textbook on geriatric palliative care and has contributed to more than 20 books on the subject of geriatrics and palliative care. As one of the leading figures in the field of palliative medicine, Dr. Morrison has appeared numerous times on television and in print to discuss his own research and to comment on matters related to older adults and those with serious illness.

Associate Professor Juliet Jacobsen, MD

Associated Professor, Harvard Medical School and Researcher, Lund University Institute for Palliative Care

Juliet Jacobsen, MD, is a palliative care clinician educator interested in communication, systems change, and the psychology of adaptation to serious illness.  She worked at Massachusetts General Hospital for 16 years and is an Associate Professor of Medicine at Harvard Medical School.  She was formerly the Fellowship Director for the Harvard Interprofessional Palliative Care Fellowship and the founding Medical Director for the Continuum Project, an MGH culture change project to improve the delivery of generalist palliative care through the implementation of the Serious Illness Care Program.  Her recent book, What’s in the Syringe? Principles of Early Integrated Palliative Care (OUP, 2021), gives palliative care clinicians a psychological framework and practical skills for the clinical practice of outpatient palliative care.  She is currently a researcher at the Lund University Institute for Palliative Care.

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