Methods and benefits of ACP for geographic populations in the U. S. have been limited to relatively small populations such as La Crosse, WI (POP. 110,000). Beginning in 2008, the Twin Cities Medical Society and its Foundations catalysed the development of a metropolitan area wide voluntary, collaborative ACP program that included major hospital systems and health care plans. This initiative, called Honouring Choices Minnesota (HCM), features Minnesota governance and implementation of a validated ACP model. More than 800 facilitators and 32 instructors have been trained and the most mature health system program is adding 2,000 health care directives to its EMR monthly. This two-part workshop will present ACP strategies and methods across systems and population subgroups. In Part I, project conceptualisation, environmental assessment, collaborative development, leadership and funding will be addressed. Other components will include establishing a medical infrastructure, staff training, pilot site development, standardised patient education, moving from pilot site to system-wide implementation, access and reimbursement. Part II discussion will focus on public engagement. Development of public engagement goals, objectives and strategies will be reviewed. The conceptualisation, development and deployment of a metro-wide broadcast and internet campaign will be presented as well as ideas for national application. The roles of strategic partnerships, community resources, media partnerships and multicultural strategies will be reviewed. HCM is an innovative ACP program, scaled to a large, diverse metro population (POP. 2.85 million), whose concepts and strategies may have broad applicability nationally and internationally.
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