Though it has brought advanced care planning to a remarkable number of people, Respecting Choices has encountered some resistance. Britt Welnetz, the organization’s business development consulÂtant, said that she is often asked whether a nonphysician facilitator can effectively discuss medical decisions. She explains that the standardized, patient-centered conversation leads to an overall level of patient satisfaction.
Others ask if the Respecting Choices model can work in a community that’s more diverse than La Crosse. Research indicates that it can. The Respecting Choices program was implemented in a hospital in MilÂwauÂkee, and the use of advance directives among racial and ethnic minorities inÂcreased substantially from 25.8 percent to 38.4 percent. Research suggests that it’s knowledge of advance directives, regardless of race and ethnicity, that leads to their use.
The advance care planning facilitator model has gained acceptance both nationally and internationally. RespectÂing Choices has trained more than 10,000 facilitators, as well as nearly 600 instructors and nearly 30 faculty members who can implement system-wide changes. There are facilitators in 47 states in the United States, and Respecting Choices is the national standard of care in Singapore and Australia; the program is also the model for an $8.5 million European Union study of advance-stage cancer patients and end-of-life care.