Rebecca Sudore

speaker

816 appearances 5 recordings 1 series first heard May 2017 last heard Mar 2022

Rebecca Sudore’s voice in public audio — every appearance, attributed to the second.

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GeriPal - A Geriatrics and Palliative Medicine Podcast · Advance Care Planning is So Right: Podcast with Rebecca Sudore and Ryan McMahan · 8 Oct 2020 podcast

She did this study where she asked nephrologists whose job is it to do advanced care planning?

And they said the primary care providers.

And you ask the primary care providers and you say who should be doing advanced care planning and they say the nephrologists.

So nobody wants to own it.

So you have this thing that people think is important and nobody wants to own it.

So if nobody owns it, how's it gonna actually take hold and move forward?

And the only way that I've ever seen it work is when leadership thinks it's important.

uh give you an example from UCSF.

So we started this pragmatic trial and advanced care planning wasn't on people's leaderboards, it wasn't top priority, and it was really hard to get anybody to talk to us.

But then UCSF entered into these sort of agreement arrangements and agreements, or something called Prime, which was a Medicaid reimbursement thing for public hospitals, where people that and they actually volunteered to have advanced care planning be one of these 80 metrics that they would get reimbursed for.

Well, all of a sudden, advanced care planning is super important, you know, to the health center.

You know, and all of a sudden we had people that we could talk to and we could start moving forward with some of this work.

But just to all, you know, say

there are different priorities that get shifted in the healthcare system.

And if advanced care planning is on top of that,

things can go in a large in a large way.

And if it's not, it can be very hard to implement these things, especially at you know, with high fidelity.

Yeah.

Um, Ryan, is it okay if I if I take this one?

Yeah, so Ryan and I've thought about this.

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