Continuing Medical Education – CME Lectures

Updating Your Potentially Inappropriate (Futile) Treatment Policy
1. Outline California’s new legal futility case: Alexander v. Scripps Memorial Hospital La Jolla
2. Discuss the ATS/AACN/ACCP/ESICM/SCCM – Policy Statement: Responding to Requests for Potentially Inappropriate Treatments in ICUs
3. Explain four categories of disputed treatments in the ICU.
4. Demonstrate questions to use to assess moral issues in time-pressured situations including how culture may impact these perspectives.

Physician Wellness
1. Define and describe burnout and resilience among physicians
2. Identify “red flags” that may indicate when a physician or colleague is at higher risk for burnout
3. Implement methods to control and manage stress while treating patients and interacting with team members
4. Prevent or manage physician stress and impairment utilizing available resources.
5. Recognize the varying levels of stress and burnout among different sub-specialties and identify cultural considerations in stress management

Unrepresented Patients – When We Don’t Know What the Patient Would Want
1. Examine our legal and ethical obligations to those who can’t speak for themselves.
2. Identify the questions to use when using the Best Interest Standard.
3. Discuss how to evaluate the quality-of-life issues found in end-of-life situations.
4. Review when to use an emergency consent or your healthcare decision making team.

Improving Your HCAHPS Scores
1. Define what patients consider to be a satisfying interaction.
2. Identify how to be an effective communicator while managing your time.
3. Demonstrate listening techniques through role playing to increase patient satisfaction.
4. Consider how these tools will respect patients from diverse populations

Helping Patients Become More Compliant
1. Discuss what is motivating the non-adherent patient to ignore our advice.
2. Demonstrate communication techniques to improve patient understanding and adherence.
3. Identify how to improve the discharge process to enhance compliance.
4. Outline how these tools will respect patients from diverse populations.

Helping Patients Make Better Medical Decisions Using Visual Conversation Tools
1. Explain how to use the “Drawing an Outcome Roadmap” to improve informed consent process.
2. Demonstrate “The Two-Hand Test” to make sure the patient’s wishes are being respected and that the treatment choice is medically beneficial.
3. Discuss how to use the “Weighing the Options” conversation tool to help patients and families evaluate the medical options.
4. Outline how these tools will respect patients from diverse populations.

Ethical and Cultural Issues in Geriatric Care
1. Discuss the developmental stages and needs of the aging senior.
2. Explain how understanding the needs of the aging senior can help us create a more optimal care plan.
3. Demonstrate communication techniques to improve the senior’s adherence to the medical plan.
4. Outline how a senior’s culture and ethnicity may be affecting care.

Challenging End-of-Life Conversations
1. Employ ethical strategies for dealing with requests for non-beneficial treatments.
2. Demonstrate communication strategies to use when the family is refusing to honor the patient’s advance directive.
3. Recognize our roles in making quality-of-life decisions for someone who can no longer speak for themselves.
4. Outline how to help people get out of denial so they can make medically appropriate decisions.

California End of Life Options Act
1. Identify the steps required by the patient and physician regarding requests for the aid-in-dying drug.
2. Define which vulnerable patient populations aren’t allowed to request an aid-in-dying drug.
3. Discuss the physician’s right to participate and not to participate.
4. Examine California’s recent statistics from the Department of Public Health.

Advance Directives – New Tools and Approaches to Improve Their Use
1. Examine our legal obligations regarding implementing advance directives.
2. Identify communication strategies to use when the family is refusing to honor the patient’s advance directive.
3. Demonstrate new tools to help patients write more meaningful and medically appropriate advance directives.
4. Discuss how to help diverse cultures feel more comfortable using advance directives.

Implementing the Advance Directive, POLST and DNR
1. Examine our legal obligations regarding implementing advance directives.
2. Identify communication strategies to use when the family is refusing to honor the patient’s advance directive.
3. Demonstrate new tools to help patients write more meaningful and medically appropriate advance directives.
4. Discuss how to help diverse cultures feel more comfortable using advance directives.

Managing Our Moral Distress When Poor Choices Are Being Made
1. Examine ethical strategies for balancing the patient’s rights with the professional’s obligations.
2. Demonstrate how to deal with emotionally charged conversations.
3. Discuss how to cope with our moral distress when patients/families are making choices we disagree with.
4, Identify improved communication strategies for diverse populations.

Making It Easier to Talk About Hospice
1. Identify what happens when we refer our patient to hospice and the benefits the patient/family will receive.
2. Demonstrate how to discuss hospice with patients and their families.
3. Describe how to support the patient/family through the dying journey.
4. Recognize and address why certain cultures are resistant to accepting hospice care.