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 Discussion: Susan Hickman, Sean Morrison, Rebecca Sudore, and Bob Arnold · 24 Mar 2022 podcast

they have the time to think about what is important to them so that they can engage with a palliative medicine physician or their hospital doctor, or for many people who need to be empowered in our society to speak up against the power differential that is there with untrained folks to get their voices heard.

So I think, again, call it what you will,

I think these things, and again, focusing on quality of life helps us right now in the moment and can help people in the future when they're having to make those decisions in the moment.

I don't know if I answered your question, but.

So I can just say, and Sean and I talked about this, and I have seen this happen in other health centers other than UCSF, and I'll just talk about the UCSF example.

By having advanced directive documents be part of a quality metric,

I can tell you that I could not get anyone sort of in the health system to be interested in any advanced care planning or care planning, palliative care, goals of care conversations.

But as soon as that thing became a quality metric, all the higher ups, it became something that went on their true north board and people were interested and they wanted to talk to palliative care and they wanted to figure out how they were going to do this.

Then they found out

hey, if we broaden this advanced care planning definition to, yes, advanced directives and POLST, but also documented goals of care conversations in the medical record,

we could get more money.

And so what the health systems did is they broadened this to what they call clinically meaningful advanced care planning, which could help at the bedside.

And these are documented discussions with a clinician and it increased funding for the health system and it increased care at the bedside.

So to get rid of it, I think would be slamming the door

again, on this important thing that we want, which is to hear the patient's voice and to help them make meaning out of their medical care.

So I'm for keeping it and expanding it to include goals of care conversations.

Oh, I think, you know, just that, you know, he also sort of agreed that some of the things that really come out in the

are outcomes that maybe weren't the initial outcomes that we were all hoping, that it was going to save the health care system and save millions and gazillions of dollars, but that it does appear to be doing something very clinically meaningful, particularly for surrogate decision makers.

It increases patients' and surrogates' satisfaction with communication, with medical care, with medical decision making, and decreases surrogate burden.

Again, that those, I think, he sort of agreed that those might be better outcomes as we move forward.

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