Vol. 49 No. 2 February 2015
Schedule With Abstracts
337
as they become more fragile and in many cases require increasing resources, including clinic and emergency department visits, home services, and hospitalizations. This session will provide a general introduction to several of the newer payment mechanisms emerging as part of the Affordable Care Act, with particular emphasis on integrated practice units (IPUs) and bundled payments. The session will also highlight the development of a bundled payment project at a large, greater-than-900-bed acute-care academic institution that incorporated palliative and supportive care interventions into the IPU care model. The session will be presented by members of the interdisciplinary team that developed this model, including palliative care and pulmonary physicians, a nurse practitioner, and a member of the healthcare system leadership team. Results from the first year of the COPD bundled payment project will be highlighted, including changes in medical care management, order sets, automated tracking and referrals for patients in the bundle, consultation with palliative and supportive care, involvement of home care and pulmonary rehabilitation, and initial financial results from the first cohort of patients.
desirable in order for the team to grow and improve. Our team made a commitment to seek formal team training in order to solidify and strengthen our collaboration. During this session we will share what we learned, including writing a program mission statement, defining team core values, identifying our own personal conflict resolution style using validated instruments, and exploring strategies to effectively address conflict using Kerry Patterson’s ‘‘Crucial Conversations Model’’ as a guide. We will discuss the benefits of conflict on an interdisciplinary team by using cases that illustrate how conflict can encourage innovation, the acquisition of new knowledge, and creative problem solving. Practical conflict resolution skills will be applied to common disagreements among members of interdisciplinary teams, and session participants will be encouraged to strategize ways to apply these skills to the interdisciplinary teams with whom they work. By the end of this session, participants will be able to describe how successful confrontation and resolution of differences engender increased trust and understanding between team members, and they will create an action plan to address interdisciplinary team conflict within their own teams.
Building a Successful Interdisciplinary TeamdLearning to Love Conflict (TH314)
A Practical Guide to Making Decisions to Withhold and/or Withdraw Life-Sustaining Treatment: Walking the Walk, Teaching the Talk (TH315)
Jennifer Kapo, MD, Yale University, New Haven, CT. Susan Crawford, MSW, Yale University, New Haven, CT. Jane Jeuland, MDiv BCC, Yale University, New Haven, CT. Leslie Blatt, MSN APRN, Yale University, New Haven, CT. Objectives Describe models of conflict resolution styles and reflect about one’s own typical approach to conflict resolution. Identify how one’s own personal conflict resolution style may lead to pitfalls in communication with team members who may have different approaches to conflict resolution. Identify reasons for, and potential sources of, conflict among members of an interdisciplinary team. Building a strong integrated team requires careful planning, commitment, and constant nurturing. This session will explore the development of a new palliative care interdisciplinary team, including the challenges and opportunities the team faced as it expanded. An effective, coordinated team must have an efficient mechanism for exchange of information. At the minimum, it requires space and a regular time to meet to share ideas and learn from each other. Given the team members’ mixture of skills and professional backgrounds, interdisciplinary collaboration is complex. A diversity of views and differences of opinion are inevitable. Conflict is both necessary and
Danielle Ko, MD, Melbourne Health, Melbourne, Australia,. Craig Blinderman, MD MA, Columbia University, New York, NY. Objectives Recognize the legal and ethical issues relevant to withholding and withdrawing life-sustaining treatment. Describe this practical and ethical framework for approaching decisions to withhold or withdraw life-sustaining treatment. Discuss the framework for educating ICU staff when the team is considering a decision to withhold or withdraw life-sustaining treatment. Although withholding and withdrawing medical treatments from the seriously ill are not new, public debate over the appropriate use of life-sustaining treatment (LST) in seriously ill patients is at unprecedented levels, driven by multiple factors, including advances in medical technology, an aging population, ballooning healthcare costs, the increasing prevalence of life-threatening chronic disease, and more patients dying within healthcare institutions. We will present a practical guide for clinicians who are faced with the prospect of withholding or withdrawing LST. We suggest clinicians approach these difficult and complex decisions in a systematic manner. We