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Advisory Council on End-of-Life Care Submits Recommendations

The Department of Health today announced the release of a report by The New Jersey Governor’s Advisory Council on End-of-Life Care. The release of the report ends the work of the Council, Screen Shot 2018-11-14 at 14.53.29which convened in September 2016 and operated independently under the auspices of the Department of Health.

The Council’s report highlights the need to improve end-of-life care delivery in New Jersey. The Report emphasizes the importance of establishing patient priorities and defining goals of care both through effective communication and better utilization of palliative care is urgent.

“New Jersey patients experience more aggressive care at the end-of-life without evidence to suggest a corresponding medical benefit, said New Jersey Health Commissioner Dr. Shereef Elnahal. “We are thankful for the experts on this panel for developing these recommendations to improve the delivery of this care in our state.”

The Council’s report includes 26 immediate and long-term recommendations for improving end-of-life care in New Jersey:

  • Create a statewide entity (e.g., Coalition or Workgroup) to implement the Council’s recommendations and further the work by identifying best practices surrounding end-of-life care.
  • Conduct robust professional training and education for providers on advance care planning, palliative care and end-of-life care.
  • Facilitate the integration of palliative care and use of standardized screening tools across the continuum of healthcare.
  • Promote the implementation of an electronic registry of Physician Orders for Life-Sustaining Treatment (POLST).
  • Allow mobile intensive care paramedics to provide non-emergency home visits to patients with chronic and serious illnesses (such as heart failure, chronic obstructive pulmonary disease, cancer, Alzheimer’s dementia, advanced Parkinson’s, and others) who need palliative care and do not qualify for home care or hospice services.
  • Increase community awareness, education and outreach to ensure more residents are thinking about, discussing and documenting wishes with their family and their healthcare providers.

Advanced care planning and counseling is central to providing high-quality end-of-care. The Department recognizes that effective communication and advance care planning are associated with less aggressive and more goal-oriented end-of-life care. Such communication can help patients avoid unnecessary care and ensure they receive care that is consistent with their goals and preferences.

The Department respectfully disagrees with the Council’s Recommendation #25 as written. “The Department acknowledges and firmly supports the rights and autonomy of patients and surrogates in deciding requests for interventions in their care, with the understanding that as much as possible needs to be done to document preferences and wishes, after patients are thoroughly informed of the potentially non-beneficial care and treatment,” added Dr. Shereef Elnahal, Commissioner of the New Jersey Department of Health.

The Department would endorse a model policy that would reflect early integration of a patient and family-centered wishes well in advance of a deteriorating clinical situation. The Department believes that early care integration with a patient, surrogate and an interdisciplinary care team would yield the greatest benefit on both the quality of end-of-life care as well as achieve costs savings.

In keeping with one of the Council’s recommendations, the release of the report coincides with National Hospice and Palliative Care Month. The Department and the Council share with the National Hospice and Palliative Care Organization the goal of increasing public awareness about the benefits of hospice and palliative care in the United States.

The New Jersey Governor’s Advisory Council on End-of-Life Care was established by statute in 2011 to advise the Governor on policy issues related to end-of-life care in New Jersey; to identify best practices and programs; formulate and recommend strategies for disseminating information to the public; and to develop goals and benchmarks to improve patient access and providing high-quality, cost-effective palliative and end-of-life care. The enabling statute was signed into law by former Governor Chris Christie on August 18, 2011 and was sponsored by Senators Ruiz, Weinberg, Grace, Vitale, Cunningham, Van Drew, Gordon, Beach, Stack and former Senator Beck. The Act will expire upon the submission of this report to the Governor and the Legislature.

To view the report visit: https://www.state.nj.us/health/advancedirective/documents/NJAdvisoryCouncil_EOL_FinalReport.pdf

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