Respecting Choices: A Case Study for Incorporating Advance Care Planning into Person and Family- Centered Health Care Delivery

By: Janet H. Forlini and Lee Goldberg
Published: February 2014

Health Policy Brief No. 9 ~ February 21, 2014

SUMMARY: Implemented in 1991 by the Gundersen Lutheran Health System in LaCrosse, Wisconsin, Respecting Choices is a comprehensive program that aims to engage patients and families in informed conversations about end-of-life decision-making. The program provides standardized materials to patients across all health settings; trains non-physician facilitators to guide patients and families in advance care planning; and implements common policies and practices for collecting, maintaining, retrieving and utilizing advance care planning documents across settings. This policy brief, the second in a series that highlights issues raised by the Campaign to End Unwanted Medical Treatment, makes the case that advance care planning can play a crucial role in ensuring that people receive the care they want throughout various stages of their lives. In the Respecting Choices model, advance care planning is an ongoing process of communication, integrated into the person-centered care routine and appropriately staged to the individual’s state of health. Increased use of advance care planning is necessary to ensure the evolution of our nation’s health care system in a manner that promotes person-centered choices in all stages of life.