In early 2017, posters began to pop up around the hospitals of UC San Diego Health titled with the acronym, “WGYLM?” Most employees and patients ignored or dismissed the vague signs. Some expressed annoyance, wondering what doctor or nurse posted the alphabet soup.
Fast forward a month and new signs were posted with the acronym spelled out: “What Gives Your Life Meaning?” Sticky notes and adjacent white boards were available to share candid responses. The boards quickly filled. Anonymous answers ranged from, “Curing my patient of Hepatitis C” to a child’s scrawl that read, “My friends, because of their kindness.”
In a matter of weeks, the boards brimmed with messages expressing hopes, dreams and gratitude. In April, the headline changed from, “What Gives Your Life Meaning?” to a different question, “Have you told anyone?”
“This was a social experiment designed to encourage employees to think about advanced care planning,” said Cassia Yi, critical care clinical nurse specialist at UC San Diego Health. “Planning for end-of-life is a topic that most people avoid. But the hospital felt it was important for our employees to have these crucial conversations so that they can help patients do the same.”
Yi and a multidisciplinary team of caregivers identified a need to increase the number of advanced care planning conversations especially for patients in Intensive Care Units (ICUs.) As patients become critically ill, it is important that their family know what treatment options are available to them.
“Our clinical teams always want to do what’s best for the patient,” said
Kyle Edmonds, MD, quality medical director for the Doris Howell Palliative Care Service at UC San Diego Health. “But to do what’s best for the patient, we have to know what they really want, and their wishes need to be documented in their medical record.”
Since the start of the project, there has been a 50 percent increase in documented advanced care conversations among patients at UC San Diego Health. The team’s goal is to receive 2000 pledges among providers and patients to discuss what gives their life meaning.
Yi and Edmonds added that end-of-life planning involves more than just issuing a health care directive. End-of-life planning involves exploring what you value and what brings you happiness. It also establishes who will make decisions on your behalf when you no longer can do it yourself.
“The conversation is a legacy that helps prepare your loved ones for all of life’s possible scenarios,” said Edmonds. “What greater gift could you give your family?”
According to the California Healthcare Foundation 2012 survey, 60 percent of respondents said that making sure that their family is not burdened by tough decisions was extremely important. Fifty-six percent said they had not communicated their end-of-life wishes. Only 23 percent had put their wishes in writing.
UC San Diego Health credits CSU San Marcos School of Nursing for providing inspiration for the advanced care planning initiative.
The week of April 17 is National Healthcare Decisions Week. UC San Diego Health is hosting a number of events to help its employees and patients initiate advanced care planning.
To learn more about Advanced Care Planning at UC San Diego Health visit: health.ucsd.edu/patients/yourhospitalstay/Pages/directives