Issue link: https://beckershealthcare.uberflip.com/i/1169964
92 CMO / CARE DELIVERY 'Dying doesn't have to be so hard': How providers can weave more humanity into end-of-life care By Anne-Marie Kommers I f B.J. Miller, MD, had not nearly died in 1990, he never would have gone to medical school. As a sophomore at Princeton (N.J.) University, Dr. Miller lost both legs and his le arm aer he climbed a parked commuter train, and an elec- trical current of 11,000 volts shot through his body. For weeks, physicians thought he was close to death. But he survived, returned to Princeton and, newly inspired by the care he received for his injuries, eventually attended medical school. As a palliative care physician and former art history major, Dr. Miller advocates for making end-of-life care more human and less medical- ized. A speech he gave on the subject was one of the most popular TED Talks in 2015. Shoshana Berger, meanwhile, was three months into grieving her father's death when she met Dr. Miller. As the editorial director for the de- sign company Ideo, she was part of a team hired to rebrand the Zen Hospice Project, where Dr. Miller previously served as executive director. Dr. Miller's human-centered approach to pallia- tive care "blew open my conception of what ag- ing and dying could look like," Ms. Berger said in an interview with Becker's. e two collaborated to write A Beginner's Guide to the End: Practical Advice for Living Life and Facing Death, which was released in July. e book draws on both authors' life ex- periences to offer advice on facing death and caring for the dying. Here, Dr. Miller and Ms. Berger discuss what clinicians and hospitals can learn from their book, the role of design in healthcare and how clinicians can build closer relationships with patients. Editor's note: e following responses were lightly edited for length and clarity. Question: What kind of message are you hoping to convey to readers with the book? Dr. B.J. Miller: First, dying doesn't have to be so hard. ere will be plenty of room for creative and joyful moments, and for beauty, too. Turn- ing your attention to this subject will reward you in many ways. Practically speaking, the book will compel you to do your paperwork and pre- pare, but it will also help you come to terms with death. Acquiring a sense of reality that includes your own demise is a very enriching process. It has a way of helping you live better while you're alive. is book is not just about making death seem less miserable; it's about making your life more remarkable along the way. Shoshana Berger: We also wanted the book to give people a feeling of not being alone. I remember feeling quite isolated as a caregiver. It can be such thankless, hard work, and oen you can feel like it's only happening to you. I'm hoping that sense of isolation can be somewhat allayed by this book because we tell a lot of sto- ries about other people who are going through it. Hopefully, the book will bring readers a sense they can reach out to other people. Q: Dr. Miller, this book is primarily targeted at patients and the loved ones caring for them. Do you think providers can learn something from the book, as well? BJM: Big yes! Because the subject is hard to wrap your head around, it's oen simplified based on the lens you're seeing it through. at's true whether you're doing hospice and palli- ative care work every day, or whether you're a chaplain, journalist or designer. In the medical world, this huge, beautiful, amazing, horrible topic oen gets reduced to symptom manage- ment and maybe a conversation about grief or God. ere's a ton in this book that I didn't know as a clinician, such as the costs involved at the end of life or closing down a person's digital ac- counts. Palliative care's holistic approach, which involves an interdisciplinary team of physicians, nurses, social workers and chaplains, represents an enormous advance in the healthcare world. But this holistic approach probably remains more of an aspiration than a reality. e subject is enormous, and there are many ways to see it that didn't come up in my training. Joint Commission: How to plan an active shooter drill for your hospital By Anne-Marie Kommers S hootings occur in hospitals every year, and a blog post from the Joint Commission provides advice on how hospitals can plan active shooter drills. Five tips from the Joint Commission: 1. Involve law enforcement in the planning and execution of active shooter drills. Police can provide feedback and assist in crafting emergency plans. Hospitals should es- pecially consider how they will communicate with law en- forcement during the event, grant law enforcement access to the building and coordinate evacuation plans for critical patients requiring police escort. 2. Hold drills in unused areas of the hospital, or areas under renovation. Warn everyone ahead of time of an impending drill and educate them on the upcoming procedure. 3. Use the three C's of community disaster preparedness: communicate, coordinate and collaborate. These elements can help a hospital respond to both a community shooter event and an active shooter in the hospital itself. 4. Ensure your hospital's compliance with standard EM.03.01.03, which requires hospitals to hold drills twice a year at each site included in the emergency plan, among other things. 5. Decide where to store in case of emergency boxes con- taining items such as floor plans, contact information and access cards. Determine how the hospital will notify those in the building of the emergency and provide updates. n