For service innovation in end-of-life care, branding and messaging matter

Abstract

Many patients over 65 with advanced chronic illness undergo medical treatment that fails to align with their preferences as the end of life approaches. In particular, unwanted hospitalizations increase in number and duration, a pattern of overtreatment that not only violates patient choice but also constitutes preventable medical waste. Existing services that align care with patient preference are underused, in part because both physicians and patients associate them with dying and denial of treatment. An innovative program developed at Sutter Health, a large integrated system in Northern California, illustrates how to remedy this situation. Nurse-led teams bring care to the residences of more than 2000 patients with advanced illness each day, increasing the quality of their care, reducing hospitalizations and lowering costs. Program branding and messaging has led to widespread acceptance, and the initiative has become a foundational component of a new Medicare payment model. Skillful branding and messaging of service innovation initiatives can help to overcome the emotional and attitudinal barriers restricting the use of current service lines, changing the focus of care for seriously-ill people from the hospital to their homes.