News via the Washington State Medical Association:
The Everett Clinic was awarded the William O. Robertson Patient Safety Award by the Washington State Medical Association for its work on improving conversations about end-of life care. WSMA Immediate Past President Dale Reisner, MD, presented the award to Elizabeth Marshall, MD, a family practice physician at the Clinic, at the opening session of the WSMA’s annual meeting on September 20 in Seattle.
After the passage of the Washington State Death with Dignity Act, The Everett Clinic recognized a need to improve end-of-life care discussions with their patients. The Clinic identified factors that resulted in patients not being able to exercise their desires and wishes at the end of life, including a lack of education about services such as palliative care and hospice, a lack of understanding about treatment options such a s CPR, intubation, ventilation and antibiotics, and a lack of consistent communication between all levels of the care team and patients.
In response, the clinic developed a two-hour class for patients and their loved ones informing them of their choices at the end of life and reviewing advance care planning documents such as advance directives and the Physician Orders for Life-Sustaining Treatment (POLST) form. The class included storytelling to highlight the impact of their potential choices and outcomes and used the well-regarded Advance Care Planning (ACP) Decisions Goals of Care Video (See the story which mentions The Everett Clinic, "Videos aim to inform patients about their medical options at the end of life," in The Washington Post.).
In addition to reaching out to patients, Drs. Elizabeth Marshall and Deb Myers developed a two-hour physician training class which covered the barriers to conversations and the ethical impetus compelling physicians to engage patients’ wishes, hospice and palliative care education, role play and practice. Over 130 physicians at The Everett Clinic completed the training, and now the course is offered county wide.
The Clinic has built multiple tools within their electronic medical record system to manage care, as well as built end-of- life resources into its intranet .
As a result of the Clinic’s efforts, end-of- life conversations per month jumped from 5.14 percent to 34 percent between 2011 and 2014. The percent of providers having no end-of-life conversations fell from 37.5 percent to zero percent . Hospice referrals have also increased.
The WSMA congratulates Dr. Marshall and The Everett Clinic on their contribution to improving patient safety and quality care in our state.
In addition to the award winner, two healthcare organizations received honorable mentions from the WSMA . The first, Aethena Gynecology Associates in Vancouver, Wash., was recognized for implementing patient safety checklists and scheduling protocols for certain office-based surgical procedures. As a result, they bridged the gap between assumption and verification that important safety procedures are being followed consistently. The second, Swedish Medical Group, was recognized for integrating Culture of Safety tools and behaviors into practice, enabling patients to have the same safe experience across the ambulatory to acute care continuum. As a result they have seen reductions in falls, chart compromises, incident reports and patient complaints.
The WSMA established the William O. Robertson Patient Safety Award in 2005 to recognize and share innovative patient safety initiatives in the ambulatory care setting. The award was named after WSMA past-president, the late William O. Robertson, MD, who was a champion for patient safety, risk management and quality improvement throughout his long and distinguished career. The WSMA has a long history of involvement in patient safety and quality improvement efforts, including the Institute for Healthcare Improvement’s 5 Million Lives Campaign and being a founding member of the Washington State Patient Safety Coalition.