Information

Release date: May 9, 2011
Termination date: May 9, 2013
Available credit: 1.25
The estimated time to complete this activity is 1.25 hours.

Statement of Need and Purpose

Establishing patient-centered goals of care and treatment limitations is an important component of care in patients facing advanced illness. At the same time, communication during serious illness can be difficult for patients as well as providers. Research has demonstrated that the ethical ideal for decision making, involving shared decision making between an informed patient and a physician knowledgeable in both the patient's values and achievable treatment outcomes, is far from the norm in clinical practice.

Improving communication about goals of care and treatment limitations requires that providers and patients (or their surrogates) develop a shared understanding of desired and achievable outcomes, which can be accomplished by incorporating key principles and a step-wise approach to the goals of care discussion. This approach leads to high levels of patient satisfaction as well as treatment decisions that truly reflect the patient's goals.

Target Audience

This activity is designed to meet the educational needs of physicians; Pharmacists; Nurses; and other healthcare professionals.

Commercial Support

This activity has received no commercial support.

Technical Requirements

This activity is offered online and requires a connection to the Internet. The activity works on a PC or Macintosh computer with the browsers Internet Explorer 7.0 and up, Firefox 2.0, AOL 9.x and up, and Safari 2.x and up. JavaScript should be enabled in all browsers, and Popups and first party cookies need to be accepted from http://www.scancme.com.

After completing this program, you should be able to:

• Appreciate the difficulties providers face in developing goals of care with patients facing advanced illness and their families.
• Recognize the ethical standards surrounding treatment decision making and the challenges in their practical application during advanced illness.
• Identify four "meta-principles" that contribute to effective goals of care discussions.
• Understand the importance of a step-wise approach to discussing goals of care and treatment limitations.

Accreditation Statement:

• SCAN Health Plan® is accredited by the Institute for Medical Quality/California Medical Association (IMQ/CMA) to provide continuing medical education for physicians. SCAN Health Plan takes responsibility for the content, quality and scientific integrity of this CME activity.
  
  SCAN Health Plan designates this Enduring Material for a maximum of 1.25 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity. This credit may also be applied to the CMA Certification in Continuing Medical Education.
  
  
• SCAN Health Plan is a provider approved by the California Board of Registered Nursing (Provider #CEP-13453). This activity has been approved for up to 1.25 contact hour(s).
  
  
• SCAN Health Plan (Provider #199) is accredited by the California Accreditation of Pharmacy Education (CAPE) as a recognized provider of continuing pharmacy education. Pharmacists completing this course prior to 2/4/2013 may receive up to 1.25 hour(s) of credit.
  
  

California Licensing Requirements:

AB 1820: This bill requires sufficient course work in the field of geriatrics for medical students and physicians to ensure that every general internist and family physician has the requisite knowledge and skills to competently treat California’s older population by the year 2010.

General internists and family physicians who have 25% or more of their patients 65 years of age or older are required to complete at least 20% (five hours per year) of their mandatory Category I CME in the field of geriatrics. All other physicians are encouraged to take courses in geriatrics including geriatric pharmacology.

Statement of Conflict Resolution and Disclosure

As a provider accredited by the Institute for Medical Quality/California Medical Association, and in accordance with the Accreditation Council for Continuing Medical Education (ACCME) Standards for Commercial Support: Standards to Ensure Independence in CME Activities, it is the policy of SCAN Health Plan to ensure balance, independence, objectivity and scientific rigor in all of its continuing medical education (CME) activities. SCAN Health Plan requires everyone who is in a position to control the content of a CME activity to disclose all relevant financial relationships with any commercial interest. This information is utilized to 1) determine if a conflict exists, 2) resolve the conflict by initiating a content validation process, and 3) advise learners of this information. Any individual who refuses to (or chooses not to) disclose relevant financial relationships will be disqualified from participating as an instructor, planner or manager and cannot have control of or responsibility for the development, management, presentation or evaluation of a CME activity certified by SCAN Health Plan. Disclosures received by SCAN Health Plan from individuals in a position to control CME content are made transparent to learners prior to participating in the activity. SCAN Health Plan discloses the following information to learners: 1) the name of the individual, 2) the name of the commercial interest(s), and 3) the nature of the relationship the individual has with the commercial interest. SCAN Health Plan also discloses to learners the name(s) of commercial interests supporting each CME activity.

Faculty and Planner Disclosures to Participants

Planners

The following planners had no relevant financial relationships with commercial interests to disclose.

• Russell Brower, MD, Medical Director, SCAN Health Plan
• Jodi Cohn, PhD, Director, Research, SCAN Health Plan
• Renee Toti McNally, CME Coordinator, SCAN Health Plan

The following planners have disclosed a relevant financial relationship

• Dan Osterweil, MD is on the speakers’ bureau for Novartis and has received grant/research support from Merck and UCLA. He is a consultant for Novartis and SCAN Health Plan.

Faculty

The following faculty had no relevant financial relationships with commercial interests to disclose.

• Ken Rosenfeld, MD

Faculty Affiliations

• Ken Rosenfeld, MD view bio
  Section Chief, Palliative Care
  VA Greater Los Angeles Healthcare System
  Associate Professor of Clinical Medicine, UCLA

Commercial Support

This activity has received no commercial support.