October 4, 2018

Initiative to promote awareness of need for advance directives

During last week’s Flulapalooza, the Center for Biomedical Ethics and Society, the Palliative Care Service, the Office for Strategy and Innovation and the Office for Health Sciences Education hosted a booth with information about advance directives for health care.

During last week’s Flulapalooza, the Center for Biomedical Ethics and Society, the Palliative Care Service, the Office for Strategy and Innovation and the Office for Health Sciences Education hosted a booth with information about advance directives for health care.

An advance directive is a document that details an individual’s wishes concerning health care during life threatening illness or injury, when they may not be able to speak for themselves.

A team of volunteers, led by Donald Brady, MD, Senior Associate Dean for Graduate Medical Education and Senior Vice President for Educational Affairs, and Krystyna Barnard, Communications Specialist for the Department of Radiology and Radiological Sciences, distributed more than 1,800 advance directive forms and information sheets to those who stopped by the booth.

In addition, almost 2,200 people completed an iPad survey assessing their perceptions of the need for advance directives and more than 200 people stopped at a table to obtain additional information.

The awareness and educational effort for employees was the first of many that are planned for upcoming months, said Bonnie Miller, MD, Senior Associate Dean for Health Sciences Education, one of the leaders of the effort.

“Ideally, all adult VUMC patients, including Medical Center employees, would have an advance directive and would have it documented in eStar,” she said. “For now, we want everyone at VUMC to be aware of this initiative.”

Jeff Balser, MD, PhD, President and CEO of VUMC and Dean of Vanderbilt University School of Medicine, made the same point in a VUMC Reporter “Rounds” column.

“We will work to assure that all adult patients have goals of care documented in eStar, including preferences for end-of-life care. These goals will be patient-oriented and clinically sound, and available to clinicians and patients at all times,” he wrote.

Those involved in the effort say that advance directives are important for the personal well-being of employees and their families, and for the quality of care VUMC provides.

“I think advance directives are a gift you give your loved ones and your providers,” said Kate Payne, JD, RN, associate professor of Nursing, who is on the staff of the Center for Biomedical Ethics and Society. “Difficult as it is to think about our own mortality, something could happen and you can’t speak for yourself. Having your wishes down on paper to guide your care can be comforting.”

“As a physician, I consider creating an advance directive as a patient-centered initiative that allows all patients to determine their own goals for a balance of health care and dying with dignity at the end of their lives,” said Shubhada Jagasia, MD, professor of Medicine and chief of staff for Vanderbilt University Adult Hospital and Clinics.

“This document allows us to honor the patient’s wishes at a time when they may be unable to actively participate in their own health care.”

Miller noted the connection between personally having an advance directive and helping patients.

“At VUMC, we want to do end-of-life care well. That means that care for everyone with serious illness is directed by their goals, values and wishes,” Miller said. “That includes all of us who work, learn and receive care at Vanderbilt.”