The NRGH Greensleeve Initiative:
• We need to approach Advance Care Planning Documentation the same way
we approach the Allergy Record
• The Advance Care Planning Record needs to be:
• Accurate
• Accessible
• Standardized
• Contextualized by patient’s values and Goals of Care
•
•
•
•
•
A hospital chart “Greensleeve” is just one component of a community-wide strategy to
provide an integrated Advance Care Planning Record to patients in Central Vancouver
Island
Pioneered in BC by Fraser Health Authority starting in 2004
Started with a dedicated project leader (a nurse) and a medical lead (lead physician
for Fraser Health hospice palliative care services)
“Greensleeve” in the acute care patient charts serves as the repository for all
advance care planning documents
For patients readmitted to acute care bed, Greensleeve from the medical records
archive chart automatically included in the active chart for current admission
HOW?
• Culture Shift
• ACP info routinely discussed and included in MD notes, GP
summaries
• Ministry of Health Materials
• “My Voice” Workbook
• Online forms for Rep 7 and Rep 9 agreements
• (pending) Online Advance Directive form
• NIDUS Guide to Personal Planning (“Stay in Charge of
Your Life”)
• PGT “It’s Your Choice” Personal Planning Tools guide
• VIHA EOL Portfolio Support
• Patient-Centred Records (mobile, transferrable)
Who What When Where How?
Where
GP and
Consultant
Office
Patient’s
Home
***How***
Who
When
•Office Greensleeve
•EMR/PITO engagement
•MD Champions
Individual MD
offices
Ongoing
•Home Greensleeve
Individual
Patients &
Families
Ongoing
Rachel
Carson and
Robin Love
NRGH
Greensleeve
Go-live
?summer
2012
Acute Care •Admission Orders
•Greensleeve
•IM / IT / Cerner Design
Started Spring
2011
Long Term
Care
•Admission Orders
•Greensleeve
•IM / IT / Cerner Design
?
?
Home
Care
Referral Forms
IM / IT / Cerner Design
?
?
Outpatient
Facilities
Referral Forms
IM / IT / Cerner Design
Greensleeve
?
?