Types of Curriculum and Certification

The communication skills curriculum includes:

• Certification programs for First Steps® (FS), Next Steps (NS), and Last Steps® (LS) ACP Facilitators and Instructors.
• Fellowship-like program to mentor and support individuals to become RC Organization Faculty (OF).
• 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 curriculum (in development) for physicians and other providers to assist in their roles of initiating and guiding basic (i.e., FS) conversations.
• Online curriculum for FS, NS, and LS.

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.

 

RC offers design and implementation programs that include:

• Leadership recommendations to integrate the RC 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, RC 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® (RC) certification programs, means that RC issues a certificate upon fulfillment of the following elements:

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

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

First Steps® (FS) is appropriate for any healthy adult over the age of 18 or who may have a chronic illness but has never prepared an advance care plan. 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 neurologic injury, and complete a basic document.

 

Next Steps (NS) is offered to patients when chronic illness becomes more advanced—when clinical triggers arise, such as complications, frequent hospitalizations/clinical encounters, or a decline in function. For a patient with heart failure, it may be a heart attack, pulmonary complications, or increased symptoms during daily living activities.

 

Last Steps® (LS) is initiated as a component of quality end-of-life care for frail elders and those whose death in the next 12 months would not be unexpected. The LS planning conversation is focused on goals of care to make timely, proactive, and specific end-of-life decisions. Ideally, these decisions are converted into medical orders that can be followed throughout the continuum of care. The Physician Orders for Life-Sustaining Treatment (POLST) program is the nationally recognized model for this stage of planning.