MADISON - Madisons health care systems will encourage patients and families to talk more about end-of-life care decisions, in an effort organized by the Wisconsin Medical Society and modeled after a pioneering program in La Crosse.

Instead of merely asking patients if they have living wills or health care power of attorney documents, hospitals and clinics will offer advance care planning discussions, generally led by nurses, social workers or clergy.

Questions range from whether to resuscitate and ventilate to what kind of music and lighting patients want to be surrounded by near death.

Were going to make sure these conversations are offered, scheduled, had, documented and brought into the medical record, said John Maycroft, a medical society policy analyst leading the project.

The effort is based on the Respecting Choices program started in 1991 at Gundersen Lutheran Health System in La Crosse. The goal is to get more people to sign advanced care directives and talk about end-of-life choices long before they become ill.

Doing that in the hospital is not the best time, said Sue Sanford-Ring, vice president for quality and patient safety at UW Hospital, where she said much of the focus will be on patients coming to primary care clinics.

Doctors are not particularly good at this, said Dr. Geoff Priest, chief medical officer at Meriter Hospital. The time never seems to be quite right.

UW and Meriter are joining Dean Health System, St. Marys Hospital, Group Health Cooperative of south-central Wisconsin and the Madison Veterans Hospital in training staff to lead the discussions. In March, theyll start offering the talks to select groups of patients.

Fort HealthCare in Fort Atkinson, Community Care Inc. in Milwaukee and ProHealth Care in Waukesha are also participating. Organizations in northern Wisconsin will be invited to join next year before a statewide community outreach effort is launched in 2014, Maycroft said.

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Madison health care to emphasize end of life care discussions