Project Information

Efforts Toward Zero Harm: Implementation of a Supportive Care Team Program in Neuromedicine

Project Description: Advance Directives assist in achieving Zero Harm by making the goals of care of the patient known to their care team. They, however, are often left out of the treatment plan discussion between doctors and patients as these conversations can be difficult to conduct and often take time. Emphasis instead is typically aimed on the cure of disease and may not focus on goals related to end-of-life goals and decisions. Without a discussion about end-of-life goals, medical intervention may “not only fail to relieve suffering, but become a source of suffering itself” (Cassell, 1982). Thus, the completion of Advance Directives in clinical settings often proves difficult without added supportive team members. Advance Directives provide a plan for future medical care in the event a patient is unable to make their own decisions, they allow the patient to determine a proxy decision-maker, and ultimately they take stress off of the patient, family, and care team. With prior discussion of end of life goals, patients often feel empowered to set their own goals and priorities in the guiding of care. The Supportive Care Team (SCT) includes a group of volunteers through Haven Hospice that was established with the goal of increasing the number of advance directives that UF Health neuromedicine patients have on file. Standard quality improvement methodology was used to develop the SCT Program and included several iterative Plan-Do-Study-Act (PDSA) cycles including implementation of various print materials, processes, and educational aides for key stakeholders. The SCT has been in place for 14 months, with the SCT attending one provider’s clinics in Neurosurgery and Neurology each Wednesday. The volunteers were trained on the purpose of the SCT, the logistics of the program, and how to correctly document their interactions with patients.

QPI: Michael, Kramer, (

Collaborators: Ciera, Hall, (; Harrison, Brandes, (; Abigail, Wolz, (

Advisors: Jacqueline, Baron Lee, (

UF Health Big Aims: Zero Harm None

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