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October 12, 2011 John C. Ropp , III, MD, Chairman, SC CSI

Summit on the Care of the Seriously Ill: An Update on the SC Coalition for the Care of the Seriously Ill ( SC CSI). October 12, 2011 John C. Ropp , III, MD, Chairman, SC CSI. The Continuum of Care: Care Transitions. The Continuum of Care: Care Transitions.

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October 12, 2011 John C. Ropp , III, MD, Chairman, SC CSI

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  1. Summit on the Care of the Seriously Ill:An Update on the SC Coalition for the Care of the Seriously Ill ( SC CSI) October 12, 2011 John C. Ropp, III, MD, Chairman, SC CSI

  2. The Continuum of Care: Care Transitions

  3. The Continuum of Care: Care Transitions

  4. The Continuum of Care: Care Transitions

  5. The Continuum of Care: Care Transitions

  6. The Continuum of Care: Care Transitions

  7. Stakeholders

  8. SC Coalition for the Care of the Seriously Ill ( SC CSI) Founding Members: SCMA, SCHA, TCC, SC Healthcare Ethics Network, LifePoint, AARP, SC Nurses Association AdditionalRepresentation: SC Bar, Lt. Gov. Office, SC DHEC EMS, SC Chaplains Assoc, SC Healthcare Assoc Mission: All persons in SC with serious, chronic, or terminal illnesses will have an active voice in the care decision process

  9. What’s the Problem? • 1. Current EOL Care often does not reflect patients’ values and preferences. • 2. EOL Care costs a lot of money compared to other healthcare expenditures.

  10. Large and Growing Problem: People with Chronic Medical Conditions • Almost 50% of U.S. population has at least one chronic medical condition, consuming 80% of healthcare resources • Hypertension is the most common chronic condition, with 50M+ people in the U.S. needing treatment for high blood pressure • 23M people have asthma, with economic costs projected at $20B in 2010 • 24M people have diabetes; one-fourth are unaware they have it • Between 2005 and 2030, the number of Americans with chronic conditions will increaseby almost 30% • 20% to 30% of all Americans are projected to have diabetes by 2050 Number of People With Chronic Medical Conditions (in millions) Sources: Partnership for Solutions, John Hopkins University; Health Affairs, 26, no. 1 (2007): 142-153

  11. Medicare Beneficiaries - Chronic Conditions & Spending Source: G. Anderson and J. Horvath, Chronic Conditions: Making the Case for Ongoing Care. Baltimore, MD: Partnership for Solutions, December 2002.

  12. 4 Aims Education/tools for healthcare professionals Toolkit with sample policies developed by physicians: C-ROS; Communication, Consent, Decision-making Process for Seriously Ill Inpatients Improve communication as patients transition across the continuum of care Identification of patient values, beliefs, and wishes regarding their own healthcare Best practices for honoring advance directives regardless of setting

  13. 4 Aims 2. Education/tools for patients and communities Advance Directives Healthcare decision making Understanding their diagnosis and what they can do 3. Appropriate relationship-centered care in all settings Establish palliative care in all SC hospitals; expand palliative care training County-level mapping of resources for chronic, serious, terminal illnesses and make information accessible

  14. 4 Aims 4. Policy/Advocacy-Legal & Regulatory Advocate for the alignment of requirements and policies related to the care and decision-making processes for the care of seriously, chronically, or terminally ill persons Consider feasibility of ‘durable DNR orders’ Consider POLST for SC (Physician Orders for Life-Sustaining Treatment Paradigm)

  15. Future Directions for SC-CSI • 4 Aims: Tools for Healthcare Professionals, Tools for Patients/Communities, Care in all Settings, Policy Advancement • Continue to pursue appropriate grants • Support local healthcare systems that pilot/study EOL care issues

  16. Future Directions for SC-CSI • Form Subcommittee level work groups to accomplish the Aims • Become the voice for EOL care issues in SC

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