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Excellent Collaboration
at the End of Life
Strategic Planning Conference
Friday, September 26th &
Saturday, September 27th
Montpelier, VT
Minutes
Friday, September 26th
5:30 pm
Attendees:
David Babbot, M.D., ACF; Zail Berry, M.D., UVM; Kathy Brandt, Moderator;
Francis Brokaw, DHMC; John Campbell, VEN; Angel Collins, VNA; Ginny Fry,
Hospice Council; Marilyn Hart, M.D., Berlin; Letha Mills, M.D.,
Bennington; Madeleine Mongan, VMS; Judy Murphy, Cancer Society; Denise
Niemira, M.D., Newport; Jill Olson, VAHHS; Bob Orr, M.D., UVM; Roseann
Palmer, R.N., Central Vermont; Diana Pierce, Central Vermont Home Health
& Hospice; Melissa Prouty, Bennington; Liza Szezepaniak, DHMC.
Kathy Brandt, our facilitator from RallyingPoints, Hospice of the
Florida Suncoast, convened the meeting. After introductions, Diana
Peirce provided a brief history of ExCEL and its accomplishments over
the years. Kathy Brandt then reviewed the ExCEL vision statement from
1999 and the vision statement from the VMS Physician Assisted Suicide
Policy adopted in 1997. The group then divided into small groups, to
develop and revise the vision (its BHAG – big hairy audacious goals)
through song/drawing/poetry. Despite the skepticism of the planning
team, the group came up with components of the vision. Kathy Brandt
then reviewed answers she received to the questions “What is ExCEL?” and
“What Can ExCEL uniquely do?” After discussion, the group worked to
draft a vision and a mission statement for ExCEL that they could bring
to the Saturday group.
Kathy Brandt introduced the discussion of possible structures for ExCEL
by reviewing coalition models from several other states. After
discussion, the group concluded that at least for the foreseeable
future, ExCEL needs an administrative home. Some in the group would
eventually like to see ExCEL become its own 501(c)(3). Zail Berry, MD
raised the potential of a good fit between ExCEL and the Vermont Program
for Quality in Healthcare (VPQHC), since ExCEL is concerned with
improving care at the end of life. VPQHC could help ExCEL determine
what the baseline of end-of life care is in Vermont, and from there
ExCEL could work on improvement. Madeleine Mongan reported discussions
with VPQHC. Cy Jordan, MD, Medical Director and Helen Riehle, Executive
Director of VPQHC are interested in talking with ExCEL about becoming
the administrative home, although they were not able to attend the
meeting this weekend.
After a long discussion about different options for structure and
governance, Marilyn Hart, MD, proposed that we have a structure that
would include partnering organizations or individuals, co-chairs
(representing diversity of geography and roles), a steering committee,
and task forces or committees. All committee chairs, along with the
ExCEL co-chairs, would make up the steering committee. There would also
be a role for the members who want to stay on the mailing lists and
participate once a year at the Lake Morey conference.
After reviewing the agenda for Saturday, the group adjourned.
Saturday,
September 27th
9 am
Attendees:
David Babbot, M.D., ACF; Zail Berry, M.D., UVM; Annette Blanchard,
Franklin County Home Health & Hospice; Kathy Brandt, Moderator; Francis
Brokaw, DHMC; Diane Caccavo, Pharmacists Society; John Campbell, VEN;
Angel Collins, VNA; Fred Crowley, M.D., Springfield; Pat Donehower,
Chittenden County VNA; Jennifer Fitzgerald, R.N., Bennington; Ginny
Fry, Hospice Council; Marilyn Hart, M.D., Berlin; Linda Johnson, St.
Johnsbury Hospice; Joan Madison, M.D., Madison-Deane Initiative; Letha
Mills, M.D., Bennington; Madeleine Mongan, VMS; Wendy Morgan, Attorney
General’s Office; Judy Murphy, Cancer Society; Denise Niemira, M.D.,
Newport; Bob Orr, M.D., UVM; Roseann Palmer, R.N., Central Vermont;
Diana Pierce, Central Vermont Home Health & Hospice;
Linda Piotrowski, MTS,
Chaplain, Central Vermont Hospital; Melissa Prouty, Bennington;
Don Swartz, Vermont Department of Health; Liza Szezepaniak, DHMC; Olivia
Ward, Northwestern Vermont Medical Center.
Kathy Brandt, the facilitator for this meeting, from RallyingPoints
Hospice of the Florida Suncoast, convened the meeting with
introductions. Diana Peirce reviewed the history and accomplishments of
ExCEL since its inception in 1997. Kathy Brandt next reviewed the
answers participants submitted to a pre-conference questionnaire. Most
answers were in the range of 1 to 2+, out of a possible 4, with 4 being
the highest possible response. The overall low results indicated a
serious need for strategic planning if ExCEL is going to survive and
accomplish its mission. The highest score (2.46) was with
respect to ExCEL’s mission to work towards community/social change
related to end-of-life issues. The lowest score (.93) concerned ExCEL’s
lack of a leadership succession plan.
The group then reviewed and worked on the vision and mission that had
been started the night before. After making considerable progress, the
task of finalizing the two statements reflecting the concerns and ideas
of the larger group was delegated to a transition team.
Before beginning the discussion of structure and governance, Kathy
reviewed the seven components of sustainable coalitions – community
ownership, recruitment, evaluation, diverse funding, mission-based
decisions, leadership plan, teamwork and collaboration. The group
decided unanimously that ExCEL should work towards being a coalition,
instead of a generic organization or membership association.
The group also decided unanimously to change the organization’s name to
Excellent Collaboration at the End of Life from Excellent Care at the
End of Life, since ExCEL was more about collaboration among various
groups and individuals around end-of-life issues, rather than providing
direct care.
The discussion of administrative home began with a review of the pros
and cons of the current administrative home, the Vermont Medical
Society, professional association for physicians with its own governance
structure and organized as a 501(c) (6) non-profit, as opposed to
another organization or an independent 501 (c)(3).
The following administrative functions needed for a coalition such as
ExCEL were identified with respect to the choice of an administrative
home. If the administrative home could not address all functions, other
resources would need to be identified.
·
Meeting planning
·
Website
·
Meeting space
·
Minutes
·
Membership list
·
Communication to
members
·
Mailing address
and phone
·
Funding for
conference calls, mailings, etc.
·
Financial
oversight of grants
·
Grant writing
Kathy Brandt then presented a diagram showing the administrative home
surrounding the governance structure outlined the previous evening –
partners, co-chairs, steering committees and committees, and members.
Wendy Morgan, proposed an alternative model with members at the base
with committees, committee chairs, a leadership council of partners and
the co-chairs in a modified pyramid arrangement. The group agreed that
the broad group of members needed to play a more prominent role in the
structure developed on Friday, but in general agreed with the co-chair,
steering committee, committee model.
The group next agreed that a transition team was needed to identify an
administrative home, formulate leadership and governance, mission, a
succession plan, identify partners, and prepare job descriptions for
all. The group next identified three committees that would deal with
process/structure issues and three committees that would deal with
projects.
Process/structure committees:
·
funding,
·
membership and
·
communication
Project committees: (Each participant identified their individual top
choices for projects and the group agreed on the following three topics
to focus on for the next year)
·
pain and symptom
control,
·
end of life
planning and choices
·
access/availability.
To
plan and design each project, Kathy suggested developing a grid that
would include
·
Data
·
Education
·
Community
Engagement
·
Standards and
·
Resources
Transition team
will include 10 members -
Zail Berry, Diana Peirce, Marilyn Hart, Madeleine Mongan, John Campbell,
Letha Mills, Denise Niemira, Roseanne Palmer, Fran Brokaw and Cy
Jordan.
The tasks identified for the transition team included
·
Asking VPQHC
about being ExCEL’s administrative home.
·
Finalizing the
vision and mission statements for ExCEL
·
Finalizing the
structure of the steering committee, committee chairs with terms,
succession plans, and job descriptions
·
Working on
membership, identifying partners, identifying funding,
Co-chairs:
Zail Berry, Letha Mills and Diana Peirce will be co-chairs.
1. Funding Committee
– Chair: Denise Niemira, Members: Judy
Murphy, Linda Piatrowski, Madeleine Mongan, Roseanne Palmer
2. Membership Committee
– Chair: Marilyn Hart. Members: Angel
Collins, Lisa Szczepaniak, Annette Blanchard, Jennifer Fitzgerald, Julie
Scott, Madeleine Mongan
3. Communication Committee
– Chair: Ginny Fry. Members: Melissa
Prouty, Fran Brokaw, Diane Caccavo, Joan Madison, Dave Babbott
4. Pain & Symptom -
Chair: Judy Murphy. Members: Fran Brokaw,
Letha Mills, Diana Peirce, Linda Johnson, Diane Caccavo, Annette
Blanchard
5. Access/Availability
– (Chair: to be decided on conference
call.) Members: Roseanne Palmer, Melissa Prouty, Lisa Szczepaniak, Wendy
Morgan, Julie Scott
·
Conference call
to be scheduled for about 10 people for 2 pm on Friday, October 17.
(Note: Chair or committee representative
should confirm with VMS – Jessa Block, Stephanie Lane or Madeleine
Mongan about scheduling conference call.)
6. End-of Life Wishes
– Chair: John Campbell. Members: Joan
Madison, Bob Orr, Fred Crowley, Angel Collins, Linda Piatrowski, Olivia
Weed.
Next meeting of
full group – will be Wednesday, November 12, 2003 from 5:30 to 8:30 p.m.
at Central Vermont Home Health & Hospice.
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