Day one
Wednesday, 2 December 2020
| Time | Session | ||
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| 8.30am | Karakia and welcome from the mana whenua
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| 8.40am | Welcome from the Health Quality & Safety Commission
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| 9.00am | Consumer stories
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| 9.20am | Māori lives matter
The stated challenge of this hui is that people’s cultural frameworks and beliefs, values, hopes, concerns and goals have not always been central to care and treatment planning. Māori people have the most pervasive, long-standing and compelling inequities in NZ. In recent years the Waitangi Tribunal and the Health and Disability system review have made unequivocal statements about the structural bias and racism extant in our health system that repeatedly devalues Māori perspectives in favour of Pākehā and biomedical paradigms. We must address these issues of inequity, structural bias and the place that being Māori, mana Māori, has in our process and system. One of the ways to do that is through working with Māori and whānau to understand and use what is most important to them to plan and deliver care that works for them. Hector Matthews will shine the spotlight on Māori inequity and the systemic biases that perpetuate inequities. He will challenge us to confront some uncomfortable truths about inequity and allow us to explore ways we can truly place people’s cultural frameworks at the centre of their care and wellbeing. |
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| 10.15am | Travelling forward while looking back - our advance care planning journey 2010 to 2020 and beyond
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| 10.45am | Morning tea
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| Concurrent sessions | |||
| 11.15am |
Closed loop ACPlanning system across the south island |
"Why don't we get to do this?" – Advance care planning and people with learning disabilities |
Strengthening Te Tiriti o Waitangi partnership |
| 11.35am | Mini Break - 5 minutes
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| 11.40am | The integration and implementation of ACP across health settings: the Canterbury story |
The use of an innovative communication tool to guide difficult palliative care conversations in aged residential care |
Whenua ki te whenua – a Māori-created advance care planning guide for whānau |
| 12.00pm | Mini Break - 5 minutes
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| 12.05pm | Nelson Marlborough Health ‘SWOOP’ team – a multidisciplinary team offering shared decision making during COVID-19 |
Capturing key medical information to protect vulnerable people during lockdown |
Kaupapa hapori - Gaining community perspective: an engagement strategy |
| 12.30pm | Q&A with Hector Matthews
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| 12.50pm | Lunch
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| 1.30pm | Leaning in to lessen fear: How structure can free clinicians, patients, and their whānau in exploring what matters most
In this plenary session, palliative care, communication, and health care systems innovation experts will discuss the principles behind the Serious Illness Care Program – a structured approach to driving more, better, and earlier conversations about what matters most to patients and their whānau dealing with serious illness with their health care teams. The team will discuss the tensions clinicians face in initiating serious illness conversations with their patients, particularly during a pandemic. Finally, we will explore ways to mitigate anxiety – on behalf of health care providers and those we serve – through structured, tested language used in iterative conversations, with a particular focus on the virtual setting. |
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| 2.00pm | Mini break
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| 2.10pm | Restoring the forgotten wisdom: How can we reclaim ordinary dying?
Medical advances have extended our life expectancy, changed where we die and made death into a medical failure instead of the natural, expected end of every life. What can health care planners and practitioners do to change public understanding of dying, so we all know more, plan better and feel less afraid? |
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| 2.40pm | Panel discussion with our afternoon speakers
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| 3.10pm | Mini break
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| Concurrent sessions | |||
| 3.20pm | Putting people with dementia at the heart of everything we do |
Benefits of initiating palliative care conversations in aged residential care facilities – resident and whānau perspective |
A bubble full of aroha: an ethnographic reflection of my mokopuna’s death during COVID-19 |
| 3.40pm | Mini Break - 5 minutes
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| 3.45pm | Recognising uncertainty and the AMBER Care Bundle |
Selling something that is free yet priceless |
Supporting advance care planning in the Samoan community in Porirua |
| 4.05pm | Mini Break - 5 minutes
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| 4.10pm | A MAP for mental health: giving consumers a voice in their care planning |
Paramedic student engagement in palliative care. How did we reframe their fear into privilege? |
ACP: a unique opportunity to ask about what matters most (spirituality in its broadest sense) |
| 4.50pm | Wrap up and day one close
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Day two
Thursday, 3 December 2020
| Time | Session | ||
|---|---|---|---|
| 8.30am | Karakia and welcome back
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| 8.45am | Consumer stories
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| 9.15am | Pulling the pieces of the advance care planning puzzle together: From the Pan-Canadian framework to a local schema
The early Canadian advance care planning implementation framework was adopted to guide advance care planning in New Zealand. In Canada this framework has evolved in the last decade. The Pan-Canadian Advance Care Planning Framework still lays the foundation for successful advance care planning implementation across the health system but now highlights the need to create shared decision-making in and with communities. There is a focus on broadening partnerships and promoting wider collaboration with different jurisdictions and systems. Fraser Health Authority in British Columbia is applying this framework to the everyday work of the regional advance care planning team and has created a schema to guide advance care planning actions, conversations and processes. This practical model supports health care workers to not only know what advance care planning tool may be best utilised in what circumstance, but how the tools work together. |
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| 9.30am | Putting it into practice: applying the Pan-Canadian ACP framework to regional and local initiatives |
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| 9.45am | Q&A session with morning speakers |
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| 10.00am | Morning tea
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| Concurrent workshops | |||
| 10.30am | WORKSHOP 1
Who gets to decide what treatment is provided? The legal framework for shared decision-making, including capacity, competency and clinical decision making is complex. This workshop will help you understand the legal framework and its application in practice. WORKSHOP 2
The Serious Illness Conversation Guide is a tool to support advance care planning conversations with seriously ill people and their whānau. At this workshop you will learn more about the tool, how to use it and what kinds of systems and processes are needed to support its use in practice. WORKSHOP 3
General practice is often an ideal place to promote and support advance care planning. This workshop will support people working in general practice to share how they are adapting their practice to make this possible and for you to explore ways to integrate it into your practice. WORKSHOP 4
This workshop will begin with a presentation of New Zealand research from University of Auckland’s Te Arai Palliative and End of Life Care Research Group. The presentation will focus on issues related to advance care planning across different care settings. International guest speakers will include Professor of Palliative Care and Ageing, Caroline Nicholson and Clinical Doctoral Research Fellow, Sarah Combes from St Christopher’s Hospice in the United Kingdom who will share their work on older people’s views of advance care planning.
Presentations will be followed by a facilitated discussion on: WORKSHOP 5
Cultural safety asks that we start with understanding our own implicit biases. This workshop will support you to think about what the potential impact of your implicit biases might have on shared decision making and to explore what you can do to minimise any harmful impact those might have. |
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| 12.30pm | Choosing Wisely and advance care planning
Dr Derek Sherwood will discuss the relationship between Choosing Wisely, a programme aiming to reduce harm to patients from unnecessary testing and treatment, and advance care planning. He will focus on the synergies of the approaches and opportunities to work together. |
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| 12.45pm | Lunch
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| 1.30pm | Moving from medical orders to shared goals of care in hospitals
Dr Alex Psirides will be joined by members of the Health Quality & Safety Commission's patient deterioration team to talk through why having a shared goals of care approach is important and how the shared goals of care principles were developed. Participants will hear how the principles and other resources can be used to support shared goals of care discussions and decisions within their organisations. |
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| 2.10pm | COVID as a catalyst. How the pandemic helped us implement shared goals of care. |
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| Concurrent workshops | |||
| 2.30pm |
WORKSHOP 6
Regardless of which way the vote goes at the polls on 17 October, the health sector will need to consider the impact on consumers and clinicians and consider how we will navigate this issue as part of shared decision-making. This workshop will offer us an opprtunity to explore what the impacts might be and how shared decision-making can support consumers and clinicians consider the issues. WORKSHOP 7
The principles of shared goals of care will be published shortly. This workshop will explore what the principles mean in practice and what teams and organisations need to be considering to support effective shared goals of care for adults in hospital. WORKSHOP 8
These are not easy conversations. To do them well we need to be empathetic and bring some of ourselves to the kōrero. They often invoke emotions for patients, their whānau and for us as the health care team. When we are supporting these conversation frequently, this can take a toll. This workshop will help you share your experiences and explore with your peers ways to look after and care for yourself and each other. WORKSHOP 9
At the heart of effective shared decision-making is the clinician's communication skill and confidence to support consumers and their whānau to think about what lies ahead, to explore their values, fears and hopes and to work with them to plan for care and treatments that aligns with that. This workshop will help you increase your understanding of the skills required through demonstration of the skills and provide you with an opportunity to practice if you choose. WORKSHOP 10
The Commission is facilitating the development and implementation of a te ao Māori quality improvement framework. At this workshop we will share the progress made to date. Together we will explore how the framework could be implemented across the health sector, and more specifically for shared decision-making improvement. At the workshop we will cover how you might use the framework in your improvement initiatives and what you would need to do so. |
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| 4.30pm | Closing remarks
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| 4.40pm | Hui ends
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