Coalition for Quality at the End of Life Meeting Highlights Debates Surrounding Advance Care Planning

The Coalition for Quality at the End of Life (CQEL) held its first statewide meeting of the year on February 17, organized by the Jewish Healthcare Foundation (JHF). Fifty-nine attendees joined the Zoom meeting, hosted by JHF COO and Chief Program Officer Nancy Zionts, MBA, and JHF Medical Advisor Judy Black, MD. The meeting featured a panel discussion examining whether advance care planning (ACP) has accomplished what it was designed to do for end-of-life care and what the future of ACP might look like. 

Panelists included Robert Arnold, MD, distinguished service professor of medicine and chief of the section of palliative care, and medical ethics director at the Institute for Doctor-Patient Communication at the University of Pittsburgh School of Medicine and medical director at the UPMC Palliative and Supportive Institute; Alexander Nesbitt, MD, hospice and palliative care physician at UPMC Susquehanna; and Emily Jaffe, MD, VP and executive medical director at Helion Healthcare. A JAMA Viewpoint from October 2021 coauthored by Dr. Arnold sparked lively debate among the medical community and inspired the focus of this session.

The panelists expressed differing views on what constitutes "success" in ACP and whether dramatic changes to the ACP process should be made based on recent research on ACP outcomes. All, however, agreed that hypothetical conversations about the future are not valuable in promoting goal-concordant care. They also recognized the importance of naming a surrogate to speak on one's behalf in a medical crisis and the value of professionals having dialogue with patients about what matters to them when facing serious illness, as opposed to a process that simply focuses on checking boxes on a form.

In addition to members of CQEL and the POLST coalition, participants in the 2022 JHF Death and Dying Fellowship also were in attendance. The next CQEL meeting is scheduled for June 27, 2022, from 3–4:30 pm and will focus on POLST.