Action Wheel Leadership

End of Life Decision Making

Leadership Project: Collaborative use of Honoring Choices and POLST


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“Spreading the work to Primary Care Providers
and hospital/clinic staff” 

Project Leaders: Kevin, ER doctor; Pat, Vice President; Roberta, Family Medicine/OB

End of Life Decisions

Kevin, Roberta and Pat identified a serious misalignment in the rollout of this end-of-life critical change.  The transition from the old 5 Wishes/DNR forms to the new Honoring Choices and POLST forms had started well.  But the rollout of this sensitive change throughout the healthcare’s complex system was not being handled consistently. 

There was confusion and uncertainty, and forms were not available in the right place at the right time.  The consequences for patients and family are potentially tragic.   Clarity over what services to provide, and which to withhold, for those facing end-of-life circumstances, is one of the highest-stake decisions healthcare provider’s faces.  Clarity and alignment with the family’s wishes is critical.

The project team identified the apparent cause, and the real underlying issue. Work is now underway to share the message, and to drive the right training and correct use of the new forms throughout the healthcare system. 

Leadership Lens: The principles learned in the program allowed the team to diagnose both the symptoms and underlying root cause of this critical misalignment.  The program’s focus on understanding and aligning the values of stakeholders has fueled the interest and energy to make sure the rollout is completed throughout the healthcare system.

Key Healthcare Impacts: 

  • Adaptiveness 
  • Patient/family communication 
  • Risk mitigation 
  • Organizational Alignment 
  • Serving Others 

Key Leadership Outcomes: 

  • Misalignment Identification 
  • Misalignment Resolution 
  • Common Ground 
  • Profound Responsibility 
  • Ownership Accountability

Physician Leadership Case Studies

Minnesota Physician Leadership

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