Respecting Choices

Implementation Services

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Respecting Choices® (RC) offers implementation packages for all 3 stages of planningFirst Steps® (FS), Next Steps (NS), and Last Steps® (LS) and Shared Decision Making in Serious Illness (SDMSI).

Each service can be implemented individually or concurrently in multiple stages as part of a longer-term implementation package. Addressing each stage of planning is crucial to having an effective system in place that will ensure individuals’ wishes are followed.

However, this does not mean that all stages must be implemented at the same time.

Many organizations elect to begin with FS implementation for several reasons:

  1. FS helps to develop a sophisticated advance care planning (ACP) infrastructure that helps build a solid foundation for the other stages of planning,
  2. FS has a robust community engagement component, and
  3. FS helps create the normalization of planning that makes NS and LS easier to implement.

Other organizations choose to start with NS or LS implementation as those target populations present the most immediate need.

Whatever the starting point, RC strongly recommends having a plan to address all stages of planning.

Deciding to engage RC for assistance with implementation is a major leadership and strategic decision requiring careful consideration. It requires an in-depth understanding of the implementation process along with thorough evaluation of the workload and resources needed to achieve it. To support decision making, RC offers Leadership Engagement consultation.

Visit For Health Systems or For Conveners for more info on implementation services.

Shared Decision Making in Serious Illness (SDMSI)

SDMSI is the newest implementation service offered by RC. It includes a physician-focused communication skills curriculum and consultation from RC to develop the systems for dissemination. The physician curriculum is designed to improve competency of physicians and other providers in the skills of shared decision-making conversations to assist individuals with serious illness make all treatment decisions that align with their goals and values.

This implementation service includes consultation for developing supportive workflows and documentation processes to improve the outcome of these person-centered conversations. In addition, RC consultation includes the mentoring and certification of qualified individuals as Instructors who are licensed to replicate the curriculum and disseminate this skill set to other physicians and providers in the organization.

Organization Faculty Certification Program

RC will provide a customized certification program for teams with an existing Organization Faculty (OF) who need to replace or expand the OF position.

This program is available to experienced teams who have completed one or more RC implementation programs. A qualified individual from the organization is selected to be mentored in the appropriate consultation and educational competencies.

The existing OF (if OF exist) must be available to support and mentor the new OF candidate in the acquisition of the new skills. If this program is to replace OF, RC will provide additional mentoring.

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