End-of-Life Decisions and Care in Hospitals
CHCD began the ECHO (Extreme Care Humane Options) project in 1994 to find community consensus on the often difficult subject of using life-sustaining treatment for those who are terminally or irreversibly ill. This was a community-wide project involving nearly 1,000 local residents in discussion groups; a telephone survey; and committees of healthcare professionals.
In January 1997, the ECHO Community Recommendations were published targeted to acute care hospitals in the greater Sacramento region. More than 6,500 copies of the recommendations were mailed on request to healthcare facilities throughout the country. Almost every hospital in the Sacramento region adopted the recommendations and instituted changes in their policies, practices and programs.
End-of-Life Guidelines for Nursing Homes
Following the publication of the ECHO Community Recommendations, CHCD convened a statewide ECHO Long-Term Care task force to address this same issue in skilled nursing facilities. In January 2000, the ECHO Nursing Facility Recommendations were published and mailed by the California Department of Health Services, Licensing and Certification, to all 1,400 skilled nursing facilities in the state. This task force became the core group that formed the Coalition for Compassionate Care of California.