Santa Clara County POLST Coalition SCCPC Danette Flippin, MSW, MSG Putting POLST Into Action March 3

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Santa Clara County POLST Coalition
(SCCPC)Danette Flippin, MSW, MSGPutting POLST
Into ActionMarch 30, 2009
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Santa Clara County
WHY
WHO

• 15 cities
• 1.8 million population
• gt50 Skilled Nursing Facilities
• 8 Acute care hospitals
• 7 Hospice agencies

HOW
WHAT
when
WHERE
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Why to Begin

• Patients being transferred unnecessarily from SNF
  to hospital and too frequently receiving unwanted
  medical intervention
• Patients documented requests for medical care
  are frequently not met
• Healthcare system lacks a standardized approach
  to documenting treatment preferences (ex SNFs
  using own
• PIT/PIC)

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Who may help to Begin

• Steve Lai, 1M.D. invited 2key players to
  create the (3SCCPC) provide POLST
  introduction/QA
• Hospitals
• Administrator, MD, RN, CM, SW, Palliative Care
• Primary Care - Geriatrics
• EMS
• SNFs
• Hospice
• Legal counsel

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Where to Begin
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How to Begin

• Outreach to SNFs
• Choosing facilities
• Established relationships
• Close proximity to hospitals planning to
  participate
• Invitation to SCCPC
• Connecting and training
• POLST program intro. to key staff members
• POLST intro. to general staff members
• POLST conversation
• Admissions coordinators
• Social services designees
• Nursing staff
• Contemplating the upkeep
• Feedback survey
• Find a champion at the facility

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How to Begin (cont.)

• Outreach to Emergency Medical Services (EMS)
• Inviting to SCCPC
• County EMS Administrator
• QM Coordinator
• Noting as self-starters
• Policy locally written
• 20 min. presentation to trainers
• Mandatory training -- EMS Updates
• Updates included private companies
• Training needs continue
• Requests for training
• Potential need for contact to private companies

• Outreach to Hospitals
• Choosing hospitals
• Established relationships
• Close proximity to participating SNFs
• Invitation to SCCPC
• Gaining support
• Informing key staff members
• Palliative care
• Medical Director
• Chief Medical Officer-value to system
• Hospitalist
• CM, SW, ED staff
• County Counsel policy
• Focusing on the cause
• Improved quality of care at EOL
• Improved communication of treatment preferences

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What is Needed to Begin and When

• Desire to make a difference
• Time
• MD lead may be helpful
• Identify colleagues/core group
• (e.g., hospice)
• Form a regularly meeting coalition
• Plan a methodical outreach

Its time!!