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Jessica Martinson: Sparking Care Conversations

The 2019 C-TAC Summit will focus on cultivating the next generation of leaders in the advanced care movement. This profile is the latest installment in a series of posts that will highlight emerging leaders in advanced care.

Fostering a trusting relationship between patients and providers is key to promoting advance care planning. Ensuring that clinicians and those receiving care are prepared to discuss end-of-life wishes is an important aspect of the work being done at Honoring Choices Pacific Northwest.

An initiative of the Washington State Hospital Association (WSHA) and the Washington State Medical Association (WSMA), Honoring Choices Pacific Northwest follows the Respecting Choices® model by offering a portal to resources and programs that encourage people to discuss and document their personal end-of-life care plans. Honoring Choices Pacific Northwest, a member of C-TAC, was recently highlighted in a spotlight on our website.

Jessica Martinson, Director of Clinical Education and Professional Development at the WSMA, co-led the design and launch of the initiative and continues to serve on the Oversight Committee. She also works as Faculty, providing consulting and training services to the program’s partnering organizations. She said that the initiative grew out of a glaring need for clinicians to have conversations with patients about their goals, values and preferences.

“As professional organizations, our priority was to prepare physicians, medical groups, hospitals and health systems to partner with their patients on advance care planning,” Martinson said.

Research suggests that clinicians understand the value of advance care planning and would like to engage in these conversations with their patients, but feel that they lack the necessary training and time to have a meaningful conversation. Honoring Choices PNW recognizes the need for a team-based approach and has already certified 275 First Steps® facilitators to lead individual and group conversations on advance care planning across the state, with plans to certify hundreds more. The next phase of the initiative is to educate physicians and advanced practitioners to have the more complex goals of care and end of life care conversations with their patients.

Physicians have told Martinson that having goals of care conversations with their seriously ill patients reminds them of why they went in to medicine, and she has heard advance care planning training referred to as a “burnout buster.”

“In this time of physician overwhelm, giving them a chance to connect with their patients on their goals and values is really powerful,” Martinson explained.

Martinson did note that concordance is a challenging issue physicians and advanced practitioners face. Care at the end of life is complex. People’s wishes may change over time, their advance directive may be ambiguous, or their physician, health care agent and loved ones may not agree on the best care path. Our north star should be to keep the patient and their loved ones at the center of the decision-making process. She said that including concordance in mortality reviews and using it as a quality measure could spark an important conversation on aligning care with patients’ wishes.

While the field does face challenges, Martinson is optimistic about the future of advance care planning. She believes that the universal nature of the subject means that everyone has the potential to drive positive change. “This is a topic that literally impacts everybody,” Martinson said. “Anyone who understands the importance of this work and is willing to apply their skillset can be a leader in this realm.”

If you would like to nominate an emerging leader in advanced care to be featured in a future profile, please contact C-TAC Communications Manager Stephen Waldron at swaldron@thectac.org.

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