1. Informational Call Conversation Ready Health Care Community December 17, 2013 2:00 PM ET Welcome!

2. WebEx Quick Reference Please use chat to “All Participants” for questions For technology issues only, please chat to “Host” WebEx Technical Support: 866-569-3239 Dial-in Info: Communicate, Join Teleconference (in menu) Raise your hand Select Chat recipient Enter Text

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4. Please type your name and the organization you represent in the chat box! Example: Doug Jones, Midwest Health System

5. Today’s Speakers Aka Kovacikova Project Coordinator Christina Gunther Murphy Director Kelly McCutcheon Adams, LICSW Director Jessica McCannon, MD Faculty

6. Agenda History of The Conversation Project and Conversation Ready Review of current Conversation Ready principles and innovative testing of the Pioneers Sponsors over the past year Details of Conversation Ready Health Care Community Next steps

7. The Conversation Project 7

8. The Current State “A new national survey released by The Conversation Project reveals that while more than 9 in 10 Americans think it’s important to talk about their own and their loved ones’ wishes for end-of-life care, less than 3 in 10 have actually held these sorts of discussions.” September 18, 2013

9. What Is The Conversation Project? National media campaign to support having all people’s end of life wishes expressed and respected Uses social and traditional media Website and tools to help people get started Working with employers, hospitals, faith-based groups Change culture around end-of-life conversations in America (and beyond)

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11. Our Goal The goal of The Conversation Project is to ensure that everyone’s end-of-life wishes are expressed and respected. www.theconversationproject.org

12. Conversation Ready

13. Perspective From the Field "When you talk about dealing with people who are nearing the end of their life and their family members, the work that we do stays with them forever. It's the same way that people tell stories about the birth of their children, they also tell stories about the death of a loved one. And I just feel like you have one chance to do it right, and if we can work harder and harder to get it right on each patient and family, then that's what we have to do. People in the hospital recognize that, even people who may not like working with patients at the end of their life, they understand that when that's their task they have one chance and they need to get it right that time. That's important." Julie Knopp, NP, Palliative Care, Beth Israel Deaconess Medical Center

14. Conversation Ready IHI is working with leading health care organizations in the US and internationally to ensure the health care delivery system is prepared to receive, record, and respect patients’ wishes The Pioneer Sponsor year spanned from October 1, 2012 to September 30, 2013 Pioneers collaborated with IHI to design and test the Conversation Ready principles for use in their own systems and for possible adoption across the US and internationally Now we are ready for Phase 2

15. Pioneer Sponsors Beth Israel Deaconess Medical Center (Massachusetts) Care New England Health System (Rhode Island) Contra Costa Regional Medical Center (California) Henry Ford Health System (Michigan) Mercy Health (Ohio) North Shore ‒ Long Island Jewish Health System (New York) St Charles Health System (Oregon) UPMC (Pennsylvania) Virginia Mason Medical Center (Washington) Contributing Sponsor: Gundersen Lutheran

16. Current Conversation Ready Principles 1. Engage with our patients and families to understand what matters most to them at the end of life 2. Steward this information as reliably as we do allergy information 3. Partner with our patients to develop appropriate goals of care 4. Exemplify this work in our own lives so that we understand the benefits and challenges 5. Connect in a manner that is culturally and individually respectful of each patient

17. Examples from the Field 1. Engage with our patients and families to understand what matters most to them at the end of life: St Charles – Heart Failure University Mercy and Contra Costa – Primary Care appointments

18. 2. Steward this information as reliably as we do allergy information Virginia Mason – Advance Directive Note Type BIDMC – IT revision NSLIJ – MOLST work with skilled nursing facilities Examples from the Field

19. Examples From the Field 3. Partner with our patients to develop appropriate goals of care Care NE – Conversation Nurse UPMC – Partners Program

20. Examples From the Field 4. Exemplify this work in our own lives so that we understand the benefits and challenges UPMC – Day of Conversation Mercy – Employee Focus Groups BIDMC – Story database

21. Examples From the Field 5. Connect in a manner that is culturally and individually respectful of each patient Henry Ford – faith community summit Contra Costa – medical interpreters

22. What Is Next?

23. Conversation Ready Health Care Community Schedule Nine month learning and innovation community with approximately 30-40 organizations Schedule: – Pre-work: January 2014 – Virtual Learning Session 1: February 2014 – In-person Learning Session 2: Spring 2014 (Boston) – Virtual Learning Session 3: October 2014 Ongoing support through faculty, listserv, extranet, change package, measurement strategy

24. What Participants Can Expect Participation in a vigorous and innovative learning community Coaching to accelerate rapid-cycle testing of the change package Peer-to-peer learning with colleagues around the country (and hopefully around the world) Teaching from expert faculty

25. Expectations of Sites Committed Senior leadership support Dedicated project team able to test at the frontline IT representation on team Commitment to join one in-person (in Boston in the spring of 2014) and two virtual Learning Sessions Participation in monthly calls Data sharing Program Fee: $12,000 plus travel to in-person meeting

26. Suggested Program Staffing We suggest that each site bring a multidisciplinary team that is empowered and energized to make change across their organization, including a senior/executive lead. IHI’s experience working with improvement teams has shown that teams with representation from organizational leadership, clinical leadership, technical experience, and day-to-day leadership are critical to driving change.

27. Questions? 27

28. How to Learn More http://www.ihi.org/offerings/MembershipsNetworks/collab oratives/ConversationReadyCommunity/Pages/default.a spx Call or email: conversationready@ihi.org Kelly McCutcheon Adams, LICSW, Director, IHI Ph: 802-879-2905