Upper Peninsula Health Care Solutions, Inc. has been awarded a grant from the Michigan Health Endowment Fund to expand the evidence based advance care planning program, Make a Plan, Share Plan. The project will improve access to advance care planning services for all adults in the Upper Peninsula through collaboration with community-based organizations and integration into health systems across the region.
Advance care planning is making informed decisions about the care that you want to receive if you should ever become unable to speak for yourself. The process involves discussions with loved ones, family and caregivers, but the decisions are yours; based on your personal values and preferences. Planning ahead ensures that your wishes are carried out and relieves the people you care about of the burden of making difficult healthcare decisions on your behalf without the benefit of your input.
The establishment of an advance care plan involves contact with a trained and certified advance care planning facilitator who will help you to identify what is important to you and reflect on your decisions about your healthcare priorities. Your ACP facilitator will also help you choose and appoint a patient advocate and assist in the development of an advance directive.
- A patient advocate is a person that you trust and who will accept the responsibility of ensuring that your wishes are carried out if you are unable to express them.
- An advance directive is a document that codifies your goals, values, and intentions in a way that helps providers to understand and follow your directions for care.
Studies indicate that there is a significant gap between individuals believing that advance care and end-of-life planning is important and those that have documented goals. The Make a Plan, Share a Plan advance care planning model, developed in partnership with Upper Peninsula Health Plan (UPHP) and Honoring Healthcare Choices – Michigan, is centered on honoring the dynamic and individualized needs of patients and addressing the shortfall identified by both patients and providers.
The project systematically improves access to advance care planning services by expanding educational opportunities to increase the number of certified advance care planning facilitators in the region. It also improves healthcare quality and care coordination by leveraging Health Information Technology to enable providers, across the state, to access advance care planning documents from a single, web-based interface.
The long-term goal of the project is to foster a sustainable advance care planning system in the region that meets the needs of both doctors and patients. Revenue from billable advance care planning services in the clinic (both in person and via telehealth technology) will allow the system to self-sustain beyond the two-year project period of the grant funding. The project will reduce healthcare costs by reducing unwanted care, while creating a culture that reduces the moral distress of physicians and better aligns care with what patients truly desire from their healthcare system.