Providers Need to Fit Important Topic into Practice Workflows


By Saralin Tiedeman, MS, OTR/L, Post-Acute Project Manager

“Advanced Care Planning,” the act of planning ahead for the “what-if’s” of life, is a very important element of healthcare that is often overlooked and underrated.

In the United States, there is still very much a “taboo” against talking about end-of-life or what an individual’s wishes may be in the event of an unanticipated illness, accident, or life-threatening injury. Families do not want to spend their cherished family time speaking about such complicated and often sad matters or topics; and doctors, as we all have experienced, have little time to spend sitting down and talking with their patients and families about such a topic.

80 percent of people state they would want to speak to the doctor about end-of-life care. However, a mere 7 percent of patients have actually done so.

In addition, 90 percent of people say speaking with their loved ones about end-of-life care is important, yet only 27 percent actually have. This gap in information- between families and their loved ones, as well as between individuals and their providers, is a huge detriment to the patient, families, and healthcare system as a whole. Unnecessary hospitalizations, unwanted tests, poor quality of life, worry, and guilt are the by-products of not having an Advanced Care Plan.


  • As providers, we need to fit this important topic into our practice workflows. Our healthcare professionals need to be trained and feel comfortable having Advanced Care Planning discussions with patients and families.
  • We need to be informed as to what forms we should be completing at what stage of life.
  • There should be a discussion and conclusions about who needs a Health Care Proxy and a MOLST (Medical Orders for Life-Sustaining Treatment)
  • What types of conversations can we bill for?
  • What types of patients should we be addressing these concerns with?
  • How can we facilitate these discussions and mobilize our patients to begin thinking proactively instead of reactively?

Advanced Care Planning is not synonymous with end-of-life care. Not only those individuals who have chronic conditions or terminal illness need to be concerned with the “what-if’s” of life, we all do. All too often we hear of the car accident on the thruway, the skiing accident in the Southern Tier, the fall off the ladder in the front yard. We are mortal beings, which means at any moment we too could be facing a critical moment where life or death decisions must be made.

P2 Collaborative of WNY Planning to Host April 15, 2017 Advanced Care Planning Conference

On April 15, the “Quality Living to the End of Life” Coalition,” led by the P2 Collaborative of WNY, will host a conference providing an opportunity for healthcare professionals to explore and learn about a variety of pragmatic and useful tools and procedures that will help them engage their patients and create more and better advance care plans.

The April event is a follow-up to the half-day training conference that took place in September 2016 where over 175 health care professionals gained additional knowledge about the importance of advance care plans while also earning continuing education credits. Credits will again be available at the April Conference.

The April Conference will also kick off 2017 National HealthCare Decisions Day (NHDD) — a week-long event from April 16 – 22, 2017 — which aims to help people across the United States understand the value of advance healthcare planning.

Historically, people in the United States face end of life care issues that often result in care that is excessive, ineffective and costly.  Too many people die without the dignity and serenity that they would have opted for had they discussed their wishes with family members and healthcare professionals in advance.

Visit for more information, as well as for valuable tools and resources on this topic.



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