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Nursing Facility EducationHome | About the Coalition | Nursing Facility Education | Professional Education | Consumer Outreach | Community-Based Coalitions | Advance Directive Education | Publications & Materials | Legislation | Hospital-Based Palliative Care | End-of-Life Links & Search Engine |
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Our work with nursing facilities was featured in the Journal of Palliative Medicine. |
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ECHO Nursing Facility Recommendations The 28-page ECHO Nursing Facility Recommendations was produced by a 22-member inter-organizational statewide task force formed in May 1997 to improve end-of-life care in California skilled nursing facilities. Known as the ECHO (Extreme Care, Humane Options) Long-Term Care Task Force, its members included the California Department of Health Services, the California Association of Health Facilities, the California Association of Homes and Services for the Aging, the California Board of Registered Nursing, and other healthcare professionals, long-term care representatives and consumer advocates. The California Coalition for Compassionate Care field-tested the Recommendations in 1999 prior to final revisions, then used them extensively in the year 2000 training program described above.
To view a PDF version of the Recommendations, click here (file size: 1.07 MB).
The California Coalition for Compassionate Care used the following materials in the April 2000 and June 2001 training programs. Many of these documents are in PDF format. To view PDF files, you must have the Adobe Acrobat Reader. If you do not already have the Acrobat Reader installed, you may download it free from Adobe's Acrobat download page. Introductory exercises The End-of-Life Decision-Making Survey consists of 18 true-false questions about advance care planning and end-of-life care. The Survey Leader's Guide describes its use. Many of the questions are specific to California. Please contact Terry Hill at thillmd@pacbell.net if you are interested in modifying the survey for other areas. The Choices and Values Exercise offers an engaging introduction to the complexities of end-of-life decision-making. See the Choices and Values-Leader's Guide. Changing practice: Section II of the ECHO Nursing Facility Recommendations, "Recommended Outcomes and Strategies," describes improvement strategies available to SNF leadership teams, healthcare professionals, conservators, regulatory agencies, professional associations and academic institutions. Here we offer four tools specifically for SNF leadership teams:
Improving practice requires understanding and changing the processes of care. Unless you are lucky enough to find a quick fix, you may need to answer a series of process improvement questions which we have borrowed from quality improvement formats such as FOCUS-PDCA. For an example of flow-charting a process, see End-of-Life Decision-Making in SNFs: The Most Common Pathways for What Really Happens. End-of-life decision-making, pain and symptom management Please see Section III of the ECHO Nursing Facility Recommendations, "Advance Care Planning." Marlys Huez, JD, and Shirley Paine, JD, have prepared a Summary of Law on Medical Decision-Making specific to California.
The following PowerPoint presentations cover additional training topics:
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Promising Practices Through our Promising Practices initiative, we worked with a small group of California nursing facilities that were doing something well in the provision of end-of-life care, provided technical assistance and mentoring to refine these practices into replicable models that can be adopted by other nursing facilities statewide and nationally. Find out more about these models. |
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Commitment to Compassionate Care
Two-Day ProgramThis program has trained 298 people representing 109 nursing facilities and other organizations in California to become model sites for the delivery of end-of-life care. Topics covered in the initial two-day training include:
Comments from Commitment to Compassionate Care Participants:
One-Day ProgramSponsored by the California Coalition for Compassionate Care (Coalition) in collaboration with the American Society on Aging (ASA). Other co-sponsors are the California Association of Health Facilities, California Association of Homes and Services for the Aging, the California Healthcare Association and the California Association of Long Term Care Medicine. The Coalition's successful Commitment to Compassionate Care program was condensed into a one-day format for skilled nursing facilities and other providers of care to seniors. The following two one-half day intensives are offered on an annual basis. A Good Death: Effective End-of-Life Care. This session explored the complexities in determining residents' preferences for care, how to elicit effective conversations and operationalize residents' goals of care, understand the impact of the law and ethics on care of the dying.The Dying and Their Family - Providing Physical and Spiritual Care. This session helped participants gain a better understanding of common symptoms that arise at the end of life, including pain, agitation, fatigue and nausea, while exploring ways to assist in alleviating physical and spiritual discomfort. |
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| This web page was last updated on
10/30/06. Home | About the Coalition | Nursing Facility Education | Professional Education | Consumer Outreach | Community-Based Coalitions | Advance Directive Education | Publications & Materials | Legislation | Hospital-Based Palliative Care | End-of-Life Links & Search Engine |
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