Advanced Illness Management Strategies - Part 1

In 2012, CPI focused on approaches to managing life in the gap —the transition period between the first-curve and second-curve economic markets, specifically in advanced illness management (AIM). Hospitals are uniquely positioned to implement best-practice strategies to integrate AIM into the normal continuum of care, and ensure that the wishes of the patient and his or her family are carried out by the entire multidisciplinary care team throughout disease progression. Effectively integrating AIM into the continuum of care will position the hospital and health system to manage the gap between the first and second curves and support the transition to the second-curve business, care and service delivery model.

The first CPI report, Advanced Illness Management Strategies, examines in depth how hospitals can increase access to AIM programs.

Defining AIM

“End of life care,” “serious illness” or “advanced illness” are some of the terms used to categorize the set of services for patients and families during the course of illness. The Coalition to Transform Advanced Care (CTAC) defines advanced Illness as “occurring when one or more conditions become serious enough that general health and functioning decline, and treatments begin to lose their impact. This is a process that continues to the end of life.” For the purpose of this report, AIM is used as the overarching term.

Goals of AIM and Strategies to Meet Them

The goals of AIM are to improve patient and family satisfaction, increase quality of care, reduce inefficiencies and increase care coordination. This will exist in an environment where:

1. All hospitals and care systems are able to support and deliver high-quality AIM;
2. All health care professionals have the knowledge and skills to provide AIM care; and
3. Every patient and his or her family have the knowledge and skills to understand the benefits of advanced illness planning.

The literature points to three key strategies that hospitals should implement to pursue the goals of well-developed AIM initiatives:

1. Access: Patient access to AIM services can be greatly increased when all hospitals and care systems are able to support and deliver high-quality AIM.
2. Workforce: Excellence in AIM depends upon educating and training all health care professionals to provide care over the continuum of health and decline.
3. Awareness: Patient and family AIM awareness and understanding of the benefits of advanced illness planning and management can be significantly raised through community wide strategies.

The second CPI report, Advanced Illness Management Strategies: Engaging the Community and a Ready, Willing and Able Workforce Part 2, expands upon the first report and explains three key AIM strategies—access, workforce and awareness—and focuses on patient and community awareness and engagement, and a ready, willing and able workforce. To access this report, go to http://www.aha.org/aim-strategies-part2