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Initiative seeks to encourage use of advance directives

Apr. 7, 2016, 9:39 AM

Panelists at Tuesday’s Ethics Grand Rounds on Advance Directives and Advanced Planning for End-of-Life Care were, from left, James Powers, M.D., Kate Payne, J.D., R.N., Carol Eck, R.N., MBA, and Keith King, community relations manager for Alive Hospice Institute. (photo by Steve Green)

Vanderbilt University Medical Center is encouraging faculty and staff to answer this question: If you became incapable of making health care decisions for yourself because of injury or illness, would your family or health care provider know your wishes for health care?

If the answer is no, consider making health care instructions in advance, also known as advance directives. Examples include a living will, advance care plan, appointment of a health care agent and durable power of attorney for health care.

The VUMC Advance Directives Implementation Committee kicked off an effort to promote advance directives on Tuesday at Ethics Grand Rounds in Light Hall. Next week, promotional materials will be available on tables in the cafeterias in The Vanderbilt Clinic and Monroe Carell Jr. Children’s Hospital at Vanderbilt, leading up to National Healthcare Decisions Day on April 16. The theme of VUMC’s campaign is “Got Yours?”

“Our VUMC ‘Got Yours’ campaign is a gentle reminder to our patients and employees that even if you are in perfect health, naming your agent and filling out a health care agent form is a simple first step that will ultimately benefit you, your family and your health care team should the unthinkable happen,” said Neesha Choma, M.D., MPH, co-chair of the committee and executive medical director of Quality and Patient Safety for Vanderbilt University Hospital and Clinics.

The committee is also partnering with Health Plus to educate faculty and staff on the importance of advance directives. A new website is available to help VUMC faculty and staff start the process at The site gives answers to frequently asked questions and has links to advance directives forms and instructions on how to complete them.

“We are trying to reach every single employee in the Medical Center,” said Carol Eck, MBA, R.N., administrative director of Vanderbilt-Ingram Cancer Center and co-chair of the committee.

Eck acknowledged that people often don’t want to talk about end-of-life planning, but said now is the best time.

“It’s easier to think about it and to have these conversations with your family while you’re well, as opposed to if something catastrophic happens or you’re diagnosed with a disease that could be terminal,” she said.

First, it’s important to sit down with one’s loved ones and start the conversation about advance directives. The next step is to designate someone to speak on one’s behalf.
Then, the wishes can be formalized on official forms, and a copy can be given to the primary care physician so the information can be included in the medical record.

“It needs to be documented in your medical record, so that if anything did happen, somebody would know who your designated decision maker is,” said Chris Wilson, MSN, R.N., director of Nursing Education and Professional Development.

Eck said the campaign to promote advance directives arose from the Advance Directives Implementation Committee’s yearlong work to revise VUMC’s advance directives policy for patients and make it easier for faculty and staff to understand patients’ wishes. It made sense to extend that work to employees.

“This is a win-win for our patients and for our staff and faculty, if we can help them be better prepared in the event that they have to make a decision when they aren’t anticipating it,” she said.

Paul Sternberg Jr., M.D., Chief Patient Experience and Service Officer and chief medical officer of Vanderbilt Medical Group, added, “Every day, our doctors and nurses confront challenges in helping families with difficult and critical health care decisions because a loved one has not created an advance care plan.

“As members of the VUMC community, we will lead by example by personally initiating these conversations for ourselves and with our families, then documenting our wishes and those of our family members. I am thrilled that the Advance Directives Implementation Committee is taking advantage of National Healthcare Decisions Day by encouraging the Vanderbilt workforce to complete their own advance directives,” Sternberg said.

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