Kaiser Permanente Adopts the Gundersen Model
Gundersen and La Crosse have drawn widespread national media attention. Dr. Ruma Kumar, palliative care specialist at Kaiser Permanente of Northern California, remembers watching news reports on NBC about Gundersen. “There’s a video that stands out in my mind of a father and a daughter,” said Kumar, “And the father was not interested in doing the planning and the daughter and the neighbors—every one of them got on his case about ‘Why aren’t you doing this? This is something you must do.’ So it’s become that level of intervention. It’s very exciting.”
In 2012, Kaiser Permanente adopted the Gundersen model and set up its own end-of-life program called “Life Care Planning.” “We were able to use some of their training materials and training workshops, and so we used those models to set up our program,” said Kumar. She added, “[Gundersen has] been at it much longer than the majority of us. They’ve had a bit of a head start and they have gotten these numbers, but we’re hoping to do the same thing over the next eight to ten years, to really get greater than ninety percent of our patients with some sort of planning done.”
Respecting Choices—A Vehicle for Spreading
Change Beyond One Hospital
One big reason for La Crosse’s overall success is the broad community outreach efforts led by Gundersen and the city’s other major hospitals. They collaborated and formed Respecting Choices, a city-wide coalition that promotes advance care planning and patient-centered care. Danielle Rathke, Gundersen’s Advance Care Planning Coordinator, has worked with Respecting Choices for the last few years. Rathke said that the coalition reached out to community leaders, community groups, social service agencies, assisted living facilities, nursing homes, and churches. “This is the one area where we said ‘We’re going to do this together,’ ” said Rathke, “We’re going to provide a high quality service to all people that we serve in this region.” A training program developed in partnership with a competing local health system, Franciscan Skemp Healthcare (a division of Mayo Health System), and other community groups helps promote a consistent approach to advance care planning among social workers, chaplains, and other volunteers who carry out community education. Respecting Choices has now expanded to a national and international program that provides evidence-based education, consultation, and materials that have been implemented in over eighty communities and organizations around the world.