Types of Curriculum and Certification

The communication skills curriculum includes:

• Building Physician Skills in Basic ACP online course to assist physicians and advanced practitioners in their roles of initiating and guiding basic (i.e. First Steps ACP) conversations.
• Certification programs for First Steps®, Next Steps™, and Advanced Steps ACP Facilitators and Instructors.
• Fellowship-like program to mentor and support individuals to become ACP/SDMSI Faculty.
• Physician and provider curriculum to learn communication skills promoting shared decision-making conversations and assisting to align care and treatment with what matters most.
• Online ACP Facilitator Curriculum (First Steps, Next Steps, and Advanced Steps).

Education alone is not sufficient to achieve success in transforming the healthcare culture. Systems must be designed that allow new workflows, processes, and materials to be hardwired into the routines of care.

 

Respecting Choices offers design and integration programs that include:

• Leadership recommendations to integrate the Respecting Choices program into strategic initiatives and position the program for long-term sustainability.
• Key elements in building an ACP infrastructure for person-centered decision making.
• Project implementation strategies to test and refine new processes and materials on a small scale prior to widespread dissemination.
• A model for continuous quality improvement based on the “Five Promises” of an ACP System.

Becoming certified is a common practice in many professions. Certification indicates that the individual has achieved a high level of knowledge and competence to conduct a specific activity or service. Currently, no other national organizations provide or approve certification in the field of advance care planning (ACP).

 

Because of its long history of providing education and having the best evidence for successful ACP implementation, Respecting Choices decided to certify those who successfully complete its curriculum and demonstrate communication skill competency.

 

Respecting Choices Certification Disclaimer

The term “certification,” as used in the Respecting Choices certification programs, means that Respecting Choices issues a certificate upon fulfillment of the following elements:

• Completion of a specified Respecting Choices educational program with standardized content and processes.
• Successful demonstration of skills associated with the specified Respecting Choices program.
• If applicable, an 80% or higher score on a written examination associated with the specified Respecting Choices program.

The Respecting Choices certification programs are not credentialed by a national accreditation body.

To achieve person-centered care, advance care planning needs to be relevant for ALL people. Yet not all people are planning for the same future decisions. The support provided them cannot be “one size fits all.” Respecting Choices conversations are tailored to the individual where they are in the decision-making process and appropriate to their stage of health.

 

First Steps® ACP – For individuals who are healthy or have early chronic illness.

First Steps ACP is the foundation for weaving ACP discussions into person-centered care and preventive healthcare for all adults. First Steps helps plan for future healthcare decisions that would be sudden, unexpected, and leave the individual unable to speak for themselves, such as a car accident, a stroke, or a contagious virus like COVID-19. The goals of this stage are to motivate patients to plan, assist in selecting a qualified healthcare agent/decision maker, provide instructions for goals of care in the event of a permanent and severe brain injury, and complete a basic advance directive document.

 

Next Steps™ ACP – For individuals who have serious illness with potential for complications.

This population is actively engaged in disease management but experiencing complications that require complex decision making. The goals of this stage of planning are to assess the individual’s understanding of the disease progression (and related treatment options), and to identify goals of care when the illness becomes more advanced. Next Steps ACP conversations help to clarify when goals of care would shift based on the patient’s clarification of unacceptable outcomes. A Statement of Treatment Preferences (SoTP) form is used to help individuals identify their preferences for specific treatments to guide the plan of care.

 

Advanced Steps ACP – For individuals who are in the last few years of life.

Advanced Steps conversations are appropriate for anyone who is seriously ill or frail or for individuals who need to prepare for more specific decisions that impact current medical orders.
Advanced Steps ACP incorporates National POLST into this stage of planning. Goals of care conversations in this stage of planning are focused on timely, proactive, and specific treatment discussions that result in a POLST form (or medical orders) that align with individual goals, values and preferences which can be followed throughout the continuum of care.