Overview:

Critical medical decisions are often made without patients and families fully understanding the medical facts and without the medical team fully appreciating a patient’s goals and values. Shared decision making can address this gap leading to prognostic concordance. Prognostic Concordance is essential in allowing patients to make decisions based on their values. This concordance allows them to make decisions based on a reasonable prognostic expectation that is agreed upon by the patient and the clinician. Communication is also central to the clinician-patient relationship. There are different communication challenges at all phases of the cancer trajectory.  These discussions are typically emotionally charged and overwhelming and require practitioners to develop trust with the patient, identify and respond to patients’ emotions, and sort out when their own emotions interfere with effective communication. 

There is a need to clearly distinguish between the use/need of an advanced directive and POLST forms. Most clinicians do not receive detailed and specific training in how to communicate effectively the complexities and differences between advance directives and POLST forms. It is imperative that clinicians are given proper training, and the necessary tools to identify the need for and encourage the use of an advanced directive and POLST forms, as well as become aware of the resources that are available at City of Hope to them regarding advanced directive accessibility. 
 

TARGET AUDIENCE:

City of Hope APPs and nurses.

    LEARNING OBJECTIVES:

    • Review goal concordant care conversations and case scenarios.
    • Incorporate advance care planning and advance directives.
    • Apply POLST forms and Ambulator DNR.
    • Utilize ACP billing codes.
    • Discuss possible barriers and biases which may impact patient care (i.e., race, ethnicity, language, gender identity/orientation, age, socioeconomic status, attitudes, feelings, or other characteristics).

    ACCREDITATION:

    ACCREDITATION STATEMENT: City of Hope is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

    CREDIT DESIGNATION: City of Hope designates this enduring activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

    The following credit type(s) are being offered for this course:

    •  AMA PRA Category 1 Credit™  1.0

    The following may apply AMA PRA Category 1 Credit™ for license renewal:

    Registered Nurses: Nurses may report up to 1.0 credit hours toward the continuing education requirements for license renewal by their state Board of Registered Nurses (BRN). AMA PRA Category 1 Credit™ may be noted on the license renewal application in lieu of a BRN provider number.

    Physician Assistants: The National Commission on Certification of Physicians Assistants states that AMA PRA Category 1 Credit™ accredited courses are acceptable for CME requirements for recertification.

     

    The following faculty have indicated no relevant financial relationships. 

    Jennifer Baecker, NP  Nurse Practitioner, Department of Supportive Care Medicine; City of Hope

    Heather Bitar, DO Assistant Clinical Professor, Division of Supportive Medicine, Department of Supportive Care Medicine; City of Hope

    Sorin Buga, MD, FACP, FAAHPM Clinical Professor; Program Director, Hospice and Palliative Medicine Fellowship; City of Hope

    Christine Jun, MD Assistant Clinical Professor of Medicine, Division of Supportive Medicine, Department of Supportive Care Medicine; City of Hope

    Navneet Kaur, MD Assistant Clinical Professor, Department of Supportive Care Medicine, City of Hope

    Joanna Luna, NP-C  Nurse Practitioner, Department of Supportive Care Medicine; City of Hope 

    Eric D. Mecusker, DO Assistant Clinical Professor, Department of Supportive Care Medicine; Core Faculty, Hospice and Palliative Care Medicine Fellowship; City of Hope

    Carey Ramirez, ANP-C, ACHPN  Nurse Practitioner, Department of Supportive Care Medicine; City of Hope

    Finly Zachariah, MD, FAAFP, FAAHPM, FAMIA  Associate Clinical Professor, Department of Supportive Care Medicine; Associate Chief Medical Information Officer; Medical Director, Informatics and Value-based Supportive Care; City of Hope
     

    Method of Participation

    • Completion of Online Module
    • Completion of Course Evaluation, which will be sent via email to course participants

    IMPORTANT:

    Course Completion Certificates and Credit (if applicable) can only be awarded to participants who:

    • Successfully complete the course
    • Have an account in the City of Hope CME System. 

    If you do not have an account in the City of Hope CME System, please click here to create it today.