Calif. Health Systems Issue Guidelines To Improve End-of-Life Care

A coalition of Southern California health systems has developed joint recommendations for providing more effective end-of-life care, KPCC's "KPCC News" reports (Roman, "KPCC News," KPCC, 5/21).

Background

A release about the guidelines notes that nearly 80% of state residents want to speak to their health care provider about end-of-life care, but only about 10% have actually done so, according to research by the California HealthCare Foundation. CHCF publishes California Healthline.

In addition, CHCF researchers found that while 82% of residents think it is important to write down their preferences for end-of-life care, fewer than 25% had done so.

Details of Coalition

The coalition, called the Los Angeles Advance Care Planning Group, is made up of nearly a dozen health systems that provide care for more than five million Californians.

Participating hospitals include:

• Cedars-Sinai Medical Center in Los Angeles;
• HealthCare Partners Medical Group and its affiliated physicians;
• Huntington Memorial Hospital in Pasadena;
• Kaiser Permanente Southern California;
• LAC+USC Medical Center in Los Angeles;
• MemorialCare Health System in Orange County;
• Olive View-UCLA Medical Center in Sylmar;
• Providence Little Company of Mary Medical Center Torrance;
• Providence TrinityCare Hospice;
• The University of Southern California's Keck Medical Center; and
• UCLA Health System (Cedars-Sinai release, 5/21).

Details of Guidelines

The coalition's guidelines recommend that health care providers:

• Encourage all patients to plan in advance for end-of-life care and make such an approach standard;
• Ensure that patients with chronic and progressive conditions have timely access to palliative care and other support services;
• Advise patients about the potential benefits and consequences of medical treatments as they relate to end-of-life care; and
• Work with patients to implement "shared-decision making" to decide what the most favorable care would be in specific scenarios.

Glenn Braunstein, vice president of clinical innovation at Cedars-Sinai and one of the coalition's leaders, said, "The time to have that conversation [about end-of-life care] is when people are well, not when they're very sick."

Braunstein also noted that planning in advance for end-of-life treatment preferences could reduce health care costs, noting that many medical expenses usually are incurred in the last month of a patient's life ("KPCC News," KPCC, 5/21).