Chris Brinneman isn’t afraid of talking about sensitive subjects.

Take death for example.

It’s a topic she’s focused on for many years. As a social worker, she’s had to have difficult discussions with patients and caregivers about the “What If…” that may occur in life and how to properly address that care decision when needed.

“I’ve seen how people can become stuck in grief and couldn’t move forward when it comes time to make decisions,” she said. “They get stuck in the could’ve, would’ve, should’ve mode and replay the situation over and over again.”

The agony many feel could have been eased with proper planning and open discussion between the patient, caregiver and provider. This is where Brinneman’s 28 years of experience in hospice and palliative care and the healthcare arena comes into play.

Brinneman is the manager of Advance Care Planning (ACP) for Parkview Health in Fort Wayne, Ind., a not-for-profit, community-based health system of primary care and specialty physicians and 10 hospitals that serves as the largest employer in northeast Indiana and northwest Ohio with more than 13,000 employees, serving a population of more than 185,000.

ACP is a process in which a patient outlines care directives to be followed in case he or she is unable to make their own decisions at the time when care is needed. Planning relieves family members from wondering if they did the right thing on a loved one’s behalf and it lets a healthcare team know how to proceed with the care plan a patient has requested.

Brinneman admits it’s a sensitive subject to broach. However, since 2017 she has noticed a switch in the mindset of both providers and patients. This is partly due to Parkview’s involvement with Qsource’s CARE Coalition of Northeast Indiana which brings together various healthcare providers, stakeholders, partners, caregivers and patients to focus on community-wide efforts across Indiana to address local issues using national trends and local know-how.

“We really wanted to get involved with a group that supported the things Parkview was already needing to do,” Brinneman said. “When we started Parkview’s ACP program in 2017, we were able to network with other community members to discuss advance care planning in regards to the care they provide. We discovered that as a healthcare community, there wasn’t a consistency in how discussions were happening between patients and providers. For the most part, the approach was to wait for people to approach providers instead of being proactive and engaging patients in the conversation.”

Through the coalition’s sharing and transparency of care practices, Brinneman said it became very clear that inconsistent documentation was common and education on how to complete documentation on the frontline was necessary.

“If a patient is admitted for care, that provider should be able to call up that patient’s electronic medical record and see immediately all their health information – name, photo, recent history and most importantly any advance care plans – and know how to proceed with providing care,” she said.

It was the interpretation and use of data that made Qsource an essential partner in developing the ACP program, Brinneman said. “Qsource helped with data mining and report development. I’m a medical social worker and not data focused. Qsource was able to provide us with data and analytic interpretation along with process management assistance. What Qsource offered really helped to allow us to understand and expand the program.”

Parkview Health has been able to spread the knowledge of the system’s ACP program through the community coalition partnership and networking opportunities. From involvement with an annual partner conference where ACP is a topic to developing patient and staff education resources, the involvement with a community coalition has lead to the development of shared common goals of spreading ACP statewide.

“What we’ve discovered is that in the beginning we were reaching out to people and telling them about ACP. Now we have people reaching out to us,” she said.

And the numbers reflect Parkview’s efforts. Take a September 2019 educational session on a Sunday afternoon at a local church in Huntington, Ind., which saw an attendance of 92 people interested in learning about ACP. The turnout, Brinneman says, is reflective of the importance of having an ACP discussion between caregivers, patients and providers.

“The transparency and willingness of those in attendance show that people are open to having conversations about this subject,” she said.

And Brinneman is pleased to share the ACP program’s overall satisfaction survey scores culled from the past three years of activities with partners, providers and the community. On a five-point scale with five being the highest score, Parkview’s ACP program has accrued a 4.9 satisfaction score by participants who found the information and program “very useful.”

Parkview Health will continue to be involved in Qsource’s community coalition, Brinneman says, with the goal of spreading the program statewide by offering training opportunities through networking and partnership opportunities the coalition makes available.

Qsource currently coordinates 10 community coalitions in Indiana. To become involved or for more information, contact Mitzi Daffron at mdaffron@qsource.org.

 

Resource: Download the Advanced Care Planning Educational Toolkit developed by Parkview Health.