About NCSI Coalition Work Groups

Our Action on Recommendations

During 2021, the Clinical Practice & Quality Work Group hosted a series of continuing education programs focused on predictive analytics, financing care, spirituality, and roles and responsibilities of clinical providers. These recorded programs featured clinical and administrative experts who offered insights and opportunities for colleagues to examine current practice and ways to more effectively provide high quality care.

Our Action on Recommendations

• DEVELOPED PLAN TO ALIGN NC MOST FORM WITH NATIONAL POLST AND SET THE STAGE FOR ELECTRONIC PORTABLE MEDICAL ORDERS A subcommittee has worked diligently to enhance portable medical orders in NC for the short and long term. Revisions have been drafted to the NC portable DNR order and to align the NC MOST with National POLST and have been reviewed with a number of stakeholders. Changes proposed to the portable DNR form do not require legislative change and are currently under review by the Ethics and Judicial Affairs Committee of the NC Medical Society, preparatory to acceptance by NC Office of Emergency Management Services (OEMS) – hopefully by mid-2022. Planning has begun related to legislative changes which would align the NC MOST with POLST and to adopt electronic documents.
• INITIATED PLANNING FOR COMMUNICATION SKILLS TRAINING SPECIFIC TO NEEDS OF HISTORICALLY MARGINALIZED AND RURAL PATIENT POPULATIONS Recognizing that communications skills training is offered at major healthcare systems, a sub-committee has proposed provider trainings focused on serving historically marginalized and rural patient populations, including an outreach to engage local community influencers. Final plans will be shaped by the results of a research study, for which The Carolinas Center (TCC) is the fiscal agent, to test use of the Serious Illness Conversation Program from Ariadne Labs in communities of color.
• SUPPORTED LEGISLATIVE EFFORT TO SIMPLIFY ADVANCE DIRECTIVE SIGNATURES The ACP workgroup took the lead in promoting legislation to simplify completion of a valid advance directive by replacing the need for BOTH two disinterested witnesses AND notarization with allowing EITHER two disinterested witnesses OR notarization. Senate Bill 666 passed unanimously in 2021 and its companion House bill is slated for consideration in the 2022 short session.
• CREATED GLOSSARY OF TERMS RELATED TO ADVANCE CARE PLANNING In order to support consistent use of messaging and reduce confusion about the various elements of Advance Care Planning the work group created a draft glossary of terms. When finalized, this will be used as a companion piece to materials and education efforts produced by the Coalition.
• PROVIDED WORKSHOPS ON ADVANCED CARE PLANNING Workshops were offered in the spring of 2022 to align with National Healthcare Decisions Day. The ACP and Clinical Practice work groups combined efforts to host a 2-part “lunch and learn” style educational offering in April 2022, focused on ACP and Goals of Care communication skills with the theme – “It’s a team sport”. This effort was supported by Area L AHEC, offering the opportunity for free education credits for various clinical disciplines, and both were well attended.

Our Action on Recommendations

• CAREGIVING COLLABORATIVE FORMATION Members of the Caregiver & Patient Experience (CPE) work group, members of two other coalitions (the North Carolina Coalition on Aging and the Children’s Complex Care Coalition of North Carolina) and other stakeholders formed the Caregiving Collaborative and began meeting in late 2021 to align efforts around support for caregivers of those with serious illness across the lifespan in North Carolina. The Caregiving Collaborative group plans to work together toward raising awareness of serious illness caregiving issues, advocating for better support for caregivers, and improving patient engagement in health care.
• NAC UNIFIED STATE STRATEGY INITIATIVE North Carolina was one of 5 states invited to participate in this National Alliance for Caregiving initiative. CPE work group members attended educational webinars on topics related to task force establishment and coalition building for advocacy to help support caregivers across the lifespan. Mentoring sessions with other states that formed caregiving coalitions and/or established caregiving task forces were invaluable for helping our group clarify its mission and continue the momentum it had built.
• HOSTED CAREGIVING FORUMS To better inform Serious Illness Coalition members on issues faced by caregivers, the work group hosted two forums in 2021. The first was a research presentation about the state of family support policies in the United States and how these may inform the work group’s efforts. The other was a screening of the documentary Caregiver: A Love Story, followed by a short discussion about challenges faced by caregivers.

Our Action on Recommendations

• Developed brand materials It’s hard to be the “Voice of Serious Illness Care in North Carolina” without a voice, right? The team met and determined many different elements of a cohesive organizational brand strategy to best support the Coalition members and each of the different work groups.
• Developed communications plan To get the Coalition’s initiatives advanced, members and Work Groups shared their primary needs in advancing the recommendations of the North Carolina Institute of Medicine’s Task Force on Serious Illness Care. One key to evolving serious illness care in North Carolina is to raise awareness of the options and opportunities that exist to own one’s health and plan for care in advance as well as build sustainable solutions with industry leaders who recognize that collective action can have much needed impact on future legislation and practices.
• Supported ACP advocacy efforts One of the many ways that the Coalition works to connect North Carolinians with their own serious illness care is through drawing attention to advance care planning (ACP) in collaboration with the ACP working group as well as encouraging increased adoption and utility of the ACP documents. The work group supported these efforts through various channels, and continue to collaborate in educating and motivating communities to make advance care planning part of their day-to-day health practices. Part of this collaboration includes the Coalition’s close communication and coordination with The Association for Home & Hospice Care of North Carolina (AHHC) along with the AHHC Governmental Affairs staff and lobbying team regarding the Coalition’s advocacy efforts, most notably SB 666.
• Built more robust website The website is a core resource where Work Groups share information and the public can access content including our recorded Friday Facts interview series with industry leaders, healthcare professionals, and community organizers from North Carolina and beyond.