Conference Program

 

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Wednesday, September 6, 2017

8:30 am

Pre-Conference Registration Opens

9:30 am – 12:00 pm

ACP CRIO Pre-Conference Workshop


Transforming healthcare through Advance Care Planning and Goals of Care Designation uptake - Learnings from Alberta

ACP CRIO is a systematic program of research to comprehensively evaluate ACP policy utilization at the provincial or system-wide level. Learnings from adopting system wide implementation, research, evaluation, and change management will be shared.


1:30 pm – 3:00 pm
Pre-Conference Sessions (Part 1)


Session 1A: CRIO


1. How do people with disabilities perceive advance care planning - Robin Gray, University of Calgary

2. Differences in survey methodology of two Advance Care Planning survey polls conducted in Alberta, Canada - Sunita Ghosh, Alberta Health Services-CancerControl

3. Efficacy of Advance Care Planning and Goals of Care Designations Discussions: A Randomized Controlled Trial and Video Intervention - Maureen Douglas, University of Alberta

4. Identification of indicators to monitor successful implementation of Advance Care Planning policies: a modified Delphi study - Patricia Biondo, University of Calgary

5. The Economics of Advance Care Planning - Konrad Fassbender, University of Alberta; Covenant Health


Session 1B: Health Care Consent, Advance Care Planning, and Goals of Care


Health Care Consent, Advance Care Planning, and Goals of Care: The Challenge to Get It Right in Ontario - Tara Walton, Ontario Palliative Care Network Secretariat


Session 1C: How to Invite Clinicians to Initiate ACP


1. How to Invite Clinicians to Initiate ACP to Residents, Patients, and Family Carers? - Luc Deliens

2. Development of a complex intervention to support the initiation of advance care planning by general practitioners in patients at risk of deteriorating or dying: a phase 0-1 study - Aline De Vleminck, Free University of Brussels & Ghent University


3:00 - 3:30 pm

Break

3:30 pm – 5:00 pm
Pre-Conference Sessions (Part 2)


Session 2A: Spirituality Based Workshop


Inviting the Voice of Spirituality within the Conversation of Advanced Care Planning - Thomas Butler, Bon Secours Health System Inc.


Session 2B: Respecting Choices and Advance Care Planning


1. Leadership Matters: Engaging and Sustaining ACP Leadership Support - Stephanie Anderson, Respecting Choices

2. Nudging: The notion of choice architecture and whether it has a place in shared decision-making - Pat Tadel, Respecting Choices

3. The Role of Social Workers in Facilitating ACP Conversations - Kathleen Ziemba, Respecting Choices

4. Interprofessional Collaboration: A Team Approach to Assure Person-centered Decision Making and Enduring Conversations - Kathleen Ziemba, Respecting Choices


Session 2C: Improving the Content of ACP Conversations


Content and Documentation of Facilitated Advance Care Planning (ACP) Conversations: How can they be improved to make a relevant impact on clinical decision making? - Jürgen in der Schmitten, Institute of General Practice, Medical Faculty of the University of Duesseldorf and Georg Marckmann, Institut für Ethik, Geschichte und Theorie der Medizin, Ludwig-Maximilians-Universität München


5:30 pm – 6:00 pm
Opening Ceremonies & Welcome Greetings


6:00 pm – 6:30 pm
Opening Keynote

The Power of Collaboration Over Competition in Achieving Person-Centred-Conversations
Linda Briggs, MSN, MA, RN, Director, Program Development and Research, Respecting Choices, A Division of C-TAC Innovations

6:45 pm – 9:00 pm
Welcome Reception



THURSDAY, SEPTEMBER 7, 2017

7:30 am

Registration Opens

7:30 - 8:30 am

Breakfast

8:30 - 8:35 am
Morning Greetings & Welcome


8:35 am - 9:05 am
Plenary Session

Are Patients “Competent” to Participate in ACP/GCDs?
Daren Heyland, MD, MSc, FRCPC, Director, Clinical Evaluation Research Unit, Kingston General Hospital

9:15 am – 10:45 am
Concurrent Sessions


Session 3A: Setting-Specific (Part 1)


1. Influence of an ACP Intervention on Documentation of End-of-Life-Issues – a Cluster Randomized Clinical Trial - Trygve Johannes Lereim Sævareid, University of Oslo

2. Advance care planning and concrete (palliative) emergency planning: The ACP-NOPA project - Barbara Loupatatzis, University Hospital Zurich


Session 3B: Ethical Issues


1. Advance care planning and patient autonomy in cancer: A qualitative study of doctor’s perspectives - Stephanie Johnson, The University of Sydney

2. Putting the cart before the horse: is there a right time to start ACP? - Sumytra Menon, National University of Singapore

3. Advance directives by proxy in German nursing homes: prevalence, formats, contents, and ethical justification - Jürgen in der Schmitten, Institute of General Practice, Medical Faculty of the University of Duesseldorf

4. "Confronting but we need to live in the real world": an interview study of patient and caregiver perspectives on Advance Care Planning in CKD - Marcus Sellars, Kolling Institute, Northern Clinical School, Faculty of Medicine, The University of Sydney, Australia


Session 3C: Prepare Workshop


Rebecca Sudore, MD, Professor, UCSF School of Medicine


10:45 - 11:00 am

Refreshment Break

11:00 am - 12:00 pm
Panel Session

Successful Strategies to Engage Clinicians and Administrators

12:00 - 1:00 pm

Lunch, Exhibits & Posters

1:15 – 2:45 pm
Concurrent Sessions


Session 4A: Setting-Specific (Part 2)


1. "What is the one thing that makes it very hard to talk to your family doctor about end-of-life medical treatments?" Examining patient barriers to talking about Advance Care Planning (ACP) with Family Physicians - Amy Tan, University of Calgary

2. Advance Care Planning in the acute hospital setting - lessons learnt from the MAPS trial - Tanja Krones, University Hospital Zurich

3. General Practioners' experience with timely end-of-life discussions. An interview study, Scientific Institute for Quality of Healthcare (IQ Healthcare) - Anne Wichmann, Radboud University Medical Center


Session 4B: Discerning Conversations for Physicians and other Providers


The Respecting Choices "Shared Decision Making in Serious Illness" Curriculum to Assist Physicians in Aligning Care with What Matters Most to Patients - Linda Briggs and Carole Montgomery, Respecting Choices


Session 4C: Improving communication about Goals of Care


With hospitalized Patients who have serious Illness: A Canadian Multi-Centre Program of Research - John You, McMaster University

Hospitalization presents an opportunity for clinicians and patients with serious illness to discuss goals of care. Without this communication, prescribed care is often inconsistent with patients' preferences. We will share findings from our experience developing, implementing, and evaluating a multi-faceted suite of tools to achieve more and better conversations about goals of care.

Findings from our research program at 3 Canadian hospitals (Calgary, Hamilton, Montreal) constitute the key material. First, we will report gaps in current goals of care communication practices identified using process mapping. Next we will review the preliminary evidence for using 4 tools aimed at increasing patient / family preparedness and clinician competencies for goals of care discussions. Then, in small groups, participants will be able to review these materialsand will be guided through exercises to discuss how they might use these tools within their own hospital settings. Finally in an interactive discussion, participants will share in learning about implementing and evaluating projects to enhance goals of care communication with patients who have serious illness.

Following this interactive workshop, participants will be able to:

    ● Describe how process mapping can be used to identify barriers and opportunities to improve goals of care discussions in hospital
    ● Review a multi-faceted suite of communication tools and create a plan to improve patient and clinician communication about goals of care within their own institution


2:45 - 3:00 pm

Break

3:00 – 4:00 pm
Plenary Sessions


ACP in the Netherlands

Agnes van der Heide, MD, PhD, Professor of Decision Making and Care at the End of Life


Serious Illness Conversations

Rachelle Bernacki, MD, MS, Assciate Director, Serious Illness Care Program, Ariadne Labs

4:00 - 4:15 PM

Closing Remarks

4:15 - 5:30 PM

Wine & Cheese Poster Walk


FRIDAY, SEPTEMBER 8, 2017

7:30 am

Registration Opens

7:30 - 8:30 am

Breakfast

8:30 - 8:35 am
Morning Greetings & Welcome


8:35 am - 9:05 am
Plenary Session

Evolution of Advance Care Planning in Federal, Provincial and Regional Canada - Three Levels of Engagement, Education and Research
Jessica Simon, MD, FRCPC, Division Head, Palliative Medicine, University of Calgary

9:15 am – 10:45 am
Concurrent Sessions


Session 5A: Health Care System


1. Definition and Recommendations for optimal Advance Care Planning: an International Consensus - Judith Rietjens, Erasmus Medical Centre

2. Evaluating uptake of a system-wide Program of Advance Care Planning and Goals of Care Designations - Eric Wasylenko, Health Quality Council of Alberta

3. Healthcare System Interactions influence Advance Care Planning in Developed Countries - Hillary Lum, University of Colorado School of Medicine and VA Eastern Colorado Geriatric Research Education and Clinical Center (GRECC)

4. When, Where and Who is Appropriate to have Advance Care Planning Conversation with our Patients? - Seiko Izumi, Oregon Health & Science University

5. An integration of Legislation and policy. How Advance Care Planning and Goals of Care Designation works in Alberta - Alexandra Kushliak, Alberta Health Services


Session 5B: Change Management (Part 1)


1. Introducing Advance Care Planning in Norwegian Nursing Homes: an Effectiveness-Implementation randomized clinical Hybrid Trial (2013 - 2017) - Irene Aasmul, The University of Bergen

2. Sustaining Advance Care Planning in a New World - Cari Borenko, Fraser Health

3. An Advance Care Planning Volunteer Service, Exploring ACP Prevalence in the Community - Linda Nolte, Advance Care Planning Australia

4. Assessing the Effectiveness of an Alberta Health Services-led Advance Care Planning Change Management Intervention to Improve Team Process and Patient Oriented Outcomes for Cardiac Patients across Four Clinical Contexts - Marta Shaw, University of Calgary


Session 5C: Serious Illness Conversations Guide Workshop


Rachelle Bernacki, Serious Illness Care Program, Ariadne Labs


10:45 - 11:00 am

Refreshment Break

11:00 am - 12:00 pm
Panel Session

Country Specific Reports

12:00 - 1:00 pm

Lunch, Exhibits & Posters

1:15 – 2:45 pm
Concurrent Sessions


Session 6A: Patient-Specific Questions (Part 2)


1. Health Care Professionals' Experiences with Conducting Advance Care Planning Conversations in Oncology: an International Focus Group Study - Marijke Kars, University Medical Center Utrecht

2. Efficacy of the PREPARE Website to Engage Patients in Advance Care Planning in Primary Care and Cancer Outpatient Care: a Prospective Study - Neha Arora, McMaster University

3. Co-Designing ACP Resources with the Korean Community in New Zealand - Shona Muir, Auckland District Health Board & the New Zealand ACP Cooperative

4. Advance Care Planning in Adolescents with Life-Threatening Illness: Dispelling Myths and Misconceptions - Jennifer Needle, University of Minnesota


Session 6B: Change Management (Part 2)


1. Co-Designing the New Zealand ACP Plan and Guide - Shona Muir, Auckland District Health Board & the New Zealand ACP Cooperative

2. A Preliminary Analysis of the Role of Systematic Advance Care Planning in Reducing Potentially Avoidable Hospitalizations of Nursing Home Residents - Susan Hickman, Indiana University

3. Advance Care Planning: National Prevalence in General Practice, Aged Care and Hospital-Interim Findings / Protocol - Linda Nolte, Advance Care Planning Australia

4. Conversations are IN! Key Facilitators in the Implementation of an Advance Care Planning & Serious Illness Conversation Program at Providence Health Care - Wallace Robinson, Providence Health Centre

5. Implementing Respecting Choices within a Midwestern Quaternary Healthcare Delivery System - Iris Boettcher, Spectrum Health


Session 6C: Enhancing ACP Community Capacity in Canada


1. Enhancing ACP Community Capacity in Canada - Sharon Baxter & Chad Hammond, Canadian Hospice Palliative Care Association

2. Serious Illness Conversation Program Initiative in a Canadian Provincial Setting - Elizabeth Beddard-Huber, BC Centre for Palliative Care


Session 6D: Workshop: Health and Legal Sector Collaboration to Support Advance Care Planning


Session Chairs: Nola Ries, University of Technology Sydney, and Elizabeth Tobin-Tyler, Brown University School of Public Health

Advance Care Planning (ACP) is an area where law and healthcare intersect. At the system level, governments have enacted laws to enable people to make advance directives and appoint substitute decision makers. At the individual level, people who wish to prepare for future periods of incapacity may seek legal advice on how to plan for a range of health, financial and other personal issues. As a result, people who have a written advance directive are more likely to have received help from a lawyer than a doctor. However, directives written in legal jargon that are not well tailored to the client’s circumstances are unlikely to be useful in guiding future medical decision-making. Greater collaboration between legal and health professions could improve the quality and effectiveness of ACP processes and documents, with benefits for clients, their loved ones, care providers, and healthcare systems.

Following this session, participants will be able to:

  • Understand health-legal Barriers and Enablers to ACP at Individual, Organizational and System Levels
  • Explain the Benefits of health-legal Collaboration and Community Action Approaches to promote APC
  • Choose Strategies to Improve the Quality and Effectiveness of ACP that align with Client Preferences, Professional Roles and Community Aspirations

1. Doctors, Lawyers and Advance Care Planning: Why Interprofessional Collaboration is Important and how it Can Happen - Nola Ries, University of Technology, Sydney

Health sector organizations have invested considerable resources in strategies to improve knowledge and uptake of advance care planning. Yet barriers persist and many people do not engage in the full range of ACP behaviours, including writing an advance directive and appointing a legally authorized decision-maker. Not engaging effectively in ACP disadvantages patients, their loved ones and their healthcare providers. This presentation is a call to action for greater collaboration between health and legal professionals to better support clients in ACP and will propose a framework to build connections between these typically siloed professions.

2. The Medical-Legal Partnership Approach for Integrating Lawyers into Healthcare Teams - Elizabeth Tobin-Tyler, Brown University

Medical-legal partnerships (MLP) are an integrated approach to service delivery in which legal assistance is connected with the provision of health care. The goal is to reduce the health-harming impacts of unmet legal needs. Such partnerships can be used to improve the uptake and quality of advance care planning, particularly for older people and those with life-limiting diagnoses. This presentation will discuss the MLP approach, which has three key aims: (1) to address clients’ legal and health needs in a coordinated manner; (2) to transform health and legal practices and institutions; and (3) to support advocacy for law and policy reform. The presentation will share examples of MLPs that involve varying degrees of service integration. Strategies for successful development, implementation and evaluation of MLPs will be presented.

3. Community Action Approaches to Support Collaborative ACP Initiatives - Amy Waller, University of Newcastle

Improving uptake of ACP requires “whole-community” approaches where health and legal professions, governmental and non-governmental organizations, civic leaders and community groups raise public awareness and support ACP activities. Community action approaches, in which a range of interventions are systematically implemented and evaluated across a community, have been implemented in trials designed to improve a range of health and lifestyle behaviours. Through collaboration, community stakeholders build capacity to implement strategies with demonstrated effectiveness in achieving desired change. This presentation will propose components of a community action approach for ACP and ways to evaluate the individual and social outcomes and cost-effectiveness of this approach.

4. Can one Size fit All? - Bernadette Richards, University of Adelaide

South Australia was one of the first jurisdictions in Australia to introduce an Advance Care Directives Act (2013) in response to a national call for greater adoption of ACP in the community. A key aim of this Act is to empower ‘individuals to give directions in relation to their future health care, residential and accommodation arrangements and personal affairs.’ A driving principle behind the legislation was the implementation of personal preferences. This presentation will consider the aspirations behind the advance care planning movement in Australia with a particular focus on the South Australian Act. While the legislation is a good first step, it has practical downsides in that it fails to realistically engage with individual preferences and potentially fails to hear the voices of the more vulnerable members of society.


2:45 - 3:00 pm

Break

3:00 – 4:00 pm
Plenary Sessions


Nationwide Implementation of ACP in German Long-Term Care Institutions: Struggling for a Consistent Quality Standard

Georg Marckmann, MPH, Institut fuer Ethik, Geschichte und Theorie der Medizin, Ludwig-Maximilians-Universitaet Muenchen


Advance Care Planning in Australia: the Past, the Present & Looking towards the Future

Karen Detering, MD, Respiratory Physician & Clinical Ethicist, Respecting Patients Choices Program, Austin Health



4:00 - 4:15 pm

Closing Remarks

4:15 - 5:30 pm

Poster Walk

6:30 pm – 9:00 pm
Conference Dinner & Keynote Presentation

Making Sense of Birth, Life & Death
Louis Hugo Francescutti, MD, PhD, MPH, FRCPC, FACPM, CCFP, FACP (Hon), ICD-D, Physician & Storyteller


SATURDAY, SEPTEMBER 9, 2017

8:00 am

Registration Opens

7:30 - 8:30 am

Breakfast

8:30 - 8:45 am
Morning Greetings & Welcome


8:45 am - 9:15 am
Plenary Session


9:30 am – 11:00 am
Concurrent Sessions


Session 7A: Research Methods


1. Using a novel Mixed-Method Approach to Study Communication during Treatment Decision Making - Kristen Pecanac, William S. Middleton Memorial Veterans Hospital

2. A Leadership Guide to Implementing Advance Care Planning Programs - Stephanie Anderson, Respecting Choices, a Division of C-TAC Innovations

3. Passing out of Place: Adolescent and young Adult Preferences for where they die meet a different Reality - Chad Hammond, Canadian Hospice Palliative Care Association

4. What's Important to Me? Acceptability and potential Utility of a novel Values Clarification Tool to facilitate Person-Centred Conversations about Goals of Care - Anna Consoli, University of Calgary - W21C


Session 7B: Education


1. Identifying Best Practices for Volunteers and Lay Health Navigators to enhance Advance Care Planning - Hillary Lum, University of Colorado School of Medicine and VA Eastern Colorado Geriatric Research Education and Clinical Center (GRECC)

2. Facilitating Goals of Care and Care Planning Discussions at End of Life: Customized Training for Oncology Fellows - Barbara Lubrano di Ciccone, Moffitt Cancer Center

3. ACP Conversation Communication Strategies and their Impact - Leigh Manson, National ACP Cooperative

4. Development and Achievement of Education for Implementing End-of-Life Discussion (E-Field) Project - a Nationwide ACP Project in Japan - Yoshiyuki Kizawa, Kobe University School

5. Advance Care Planning and Tomorrow's Clinicians - Karen Petersen, Honoring Choices Minnesota


Session 7C: Patient-Specific Questions (Part 2)


1. Advance Care Planning (ACP) in Patients with incurable Cancer: a randomised controlled Trial of a Nurse led Intervention - Stephanie Johnson, The University of Sydney

2. Uptake, Impact and Cost-Effectiveness of a Nurse-led faciltiated Advance Care Planning Intervention: A randomised controlled trial among patients with severe Respiratory Disease - Craig Sinclair, University of Western Australia

3. Presentation Matters in Advance Care Planning and Goals of Care Conversations - Sara Davison, University of Alberta

4. Congruence in Treatment Preferences Decreases Suffering among Adolescents Living with HIV/AIDS through Facilitated Advance Care Planning Conversations - Maureen Lyon, Children's National Health System: The George Washington University School of Medicine and Health Sciences


Session 7D: Workshop - Advance Care Planning, Whose Job?


1. Advance Care Planning, Whose Job? - Josie Dixon, PSSRU, LSE

2. Examining the Use of a Guideline for ACP-Conversations in Nursing Homes - Lisbeth Thoresen, University of Oslo


11:00 - 11:30 am

Refreshment Break

11:30 - 11:45 am

Poster Awards

11:45 am - 12:00 pm

Invitation from the 2019 Conveners

12:00 - 12:30 pm

Final Remarks - Setting the Agenda for the next two Years - Farewell & Closing