VA training resources in the comprehensive PPC approach were based on the ACP Modules. They offer asynchronous training videos on the ‘identify’ step and ‘care alignment’ steps and detailed discussion of strategies for decision making. However, we strongly recommend that VA health care providers use the TMS training modalities listed below as these were adapted for the VA health care system.
This online, knowledge-based video training will introduce the first core step of the Patient Priorities Care approach: Identifying Priorities. Patient priorities are defined as meaningful health outcomes goals related to What Matters to a Veteran and what the Veteran is willing and able (or not willing and able) to do in service of those meaningful health outcome goals. The identification of patient priorities is a critical first step to simplify complex medical decision-making care plans guided by a Veteran’s own priorities is a standard of care that all members of the care team can organize around. It is also preferable to the risk and burden of addressing simply what is the matter, condition by condition.
Persons who complete this training module, regardless of clinical background (i.e. MD/DO, ARNP, PA, SW, OT, PT, Pharm D, Psychologists, LPN, Whole Health Coach, Chaplains, etc.) can be considered a PPC Facilitator. Trainees in these professions can also undergo this training and practice as a facilitator, if in the appropriate supervised setting.
This online, knowledge-based video training will teach learners to use the second core step of the Patient Priorities Care approach: Aligning Care to Identified Priorities. Patient priorities are defined as meaningful health outcomes goals related to What Matters to a Veteran and what the Veteran is willing and able (or not willing and able) to do in service of those meaningful health outcome goals. The alignment of care to patient priorities is a critical first step to simplify complex medical decision-making. Care plans guided by a Veteran’s own priorities is a standard of care that all members of the care team can organize around. The training to align decision-making and current care planning with identified patient priorities will bridge the knowledge gap between understanding What Matters and doing what works for Veterans. This training is appropriate for clinicians who are in a position to algin care such as prescribing licensed independent providers (i.e. ARNP, MD/DO, PA) and in some cases, non-prescribers (psychologists, PT/OT/ST, Pharm D, SW, RN, etc).
- Provided by a clinician trained and experienced in the PPC approach (see below). This reinforces PPC fundamentals, language skills required to develop specific, realistic, and actionable health outcome goals (especially for challenging cases).
- PPC trainers can directly observe OR review chart notes / PPC conversations for completeness and content. We additionally recommend the PPC Trainer observe or review 2-3 new facilitator conversations before deeming them independent in the process
- This Chart Review Tool can be helpful in documenting the completeness of a facilitator’s conversations for identifying priorities/step 1 for all 5 core elements.
- The Patient Health Priorities note and note template that can document facilitator encounters and the ‘identification’ of a specific patient health priorities.
- This template can be used within a specific ‘Patient Health Priorities’ note OR can be inserted into any note title you prefer.
- This note and note template can be used in conjunction with the ‘Age-Friendly 4M’s National Health Factor’ template to help capture your work as an age-friendly provider. Health factors specific to patient priorities care (thus capturing the use of this framework to determine ‘what matters’) are embedded in the patient health priorities template AND the Age-Friendly 4M’s template.
- Conditions for selecting these health factors
- Select ‘Yes’ for the ‘What Matters’ section of the Age-Friendly Template if you ask and act on what matters in your note/clinical encounter
- Select ‘PPC Approach was used to ask and identify what matters’ if a specific health outcome goals which align with patient values or ‘what matters’ was created and documented during the clinical encounter
- Select ‘The one thing that matters to the Veteran was used to align the current care plan’ if you used the PPC approach to align care around what matters and make recommendations in service of that value and health outcome goal
- Please note that the patient health priorities note and template were locally developed at VA Puget Sound. You and your CAC team at your local VA facility can request these templates and insert them into your local CPRS. Please email our PPC admin team at PatientPrioritiesCare2@va.gov for instructions on how to get the templates.
- Training for how to use the template and associated health factors can be found here
- An example ‘Patient Health Priorities’ template can be found here