University of South Dakota
Report date
December 2018
What has been most instrumental to your progress?
The Advance Care Planning: Quality Conversations coalition uses an evidence-based Advance Care Planning (ACP) method called Respecting Choices®. The education of a self-sustaining, tiered system of instructors, and facilitators, who are in direct dialog with the community was a key element for success. In return for receiving training through Advance Care Planning: Quality Conversations, facilitators commit themselves to teaching at least two workshops to members of the community in which they live or work. This puts them in direct dialog with the communities.Our approach creates a pipeline of skilled personnel which grows as trained facilitators transmit their Advance Care Planning skills and knowledge to the broader community, thus amplifying the effects of training they have received in a chain reaction.
The interprofessional coalition-building process was supported by organizational structures that remained flexible to support long-term engagement of coalition members. Activities that were instrumental for progress were: A committed leadership team that met once a month to set an agenda, organized activities and had flexibility to respond to problems. The leadership team guided the formulation of a clear mission statement. A separate membership team meeting was held every two months to explain the program, provide answers to questions, discuss feasibility of individual projects and to plan and set a timeline. Debriefings about the success of activities were done as part of the membership meetings. Critical advantages in community outreach were that USD Nursing had five campus locations across South Dakota and that diverse professions participated and provided different perspectives on how to provide Advance Care Planning for a diverse population.
Early conversations with two of the major health care providers in the state made it clear to coalition members that it would not be practical to promote a single Advanced Directive (AD) form. The providers explained that they preferred to stick with their existing AD forms. The Advance Care Planning: Quality Conversations coalition accepted this reality and instead focused on ACP as a lifelong process as promoted by Respecting Choices. This strong commitment to the process steered the coalition to focus on educating ACP instructors and facilitators who would then start conversations about ACP.
Reflections on inclusive, collaborative or resourceful problem-solving
Inclusive: Geographically diverse regions, micropolitan and metropolitan areas, many different professions and non-profits, as well as educators and care providers are members of the coalition. Underrepresented minorities are included in the training. Collaborative: geographically and professionally diverse group of professionals have established a lasting coalition with a common mission. Despite leadership changes, the core nursing leaders from USD have remained constant and the major partner institutions loyal to the project. Ten of the founding member organizations are still active after three years. Resourceful: Another crucial factor has been consistent support for training and professional development from the academic partner and community foundations in terms of financing, technology and human resources. This has allowed us to build a system of Advance Care Planning Instructors and Trainers who have the skills to amplify their knowledge by interacting directly with community members through workshops.
Understanding the problem
Thus far, the funds have been used to certify and train four Respecting Choices ® Instructors. Two are USD faculty members and two are community partners . Additionally, 41 facilitators, have been trained through the Advance Care Planning: Quality Conversations coalition. More are scheduled to take the training. To obtain First Steps® Facilitator certification, applicants commit themselves to conduct and organize at least two community workshops. Through this process,7 ACP workshops have been conducted that have reached 233 community members. Workshop locations included campus locations, hospitals, health care centers, diners, assisted living or wellness centers and nursing homes. The First Steps® facilitator course was viewed as effective by the trainees as indicated by results from the Facilitator-Questionnaire in pre- post-test comparisons. Scores improved significantly after the First-Steps® training compared to before training . In addition, when the Public Knowledge-Questionnaire was administered to community members post ACP workshop, scores in ACP knowledge improved significantly. This indicates that our training methods are effective
One last thought
Using grant money we have established a website to better communicate about our program with community members. Have a look at our website
http://www.advancedcareplanningsd.com/
http://www.advancedcareplanningsd.com/