Gundersen Health System


Patients and their caregivers often are not asked what care they want, and not given options to make good decisions. Instead, they get care that providers deem best. Advance care planning is the process of coming to understand, reflect on, discuss and plan for a time when you cannot make your own medical decisions.

The goal of advance care planning is to develop a plan that reflects your informed decision whatever they may be and to make sure that those close to you know and support that plan. The ultimate goal is to make sure you receive the best care possible, as you have decided, based on all the information, even when you cannot participate in your own decisions.

Respecting Choices® is a comprehensive, community-wide program, created and led by healthcare organizations and state and local medical societies. Owned and operated by Gundersen Health System, based in La Crosse, Wis., its mission is to engage patients and their families in informed conversations about advance care planning and to improve the systems and processes used to collect and store advance care planning decisions in patients’ medical records. The program provides standardized, locally developed patient education materials to patients across all healthcare settings in the community; trains non-physician facilitators to guide patients and their families in advance care planning; and implements common policies and practices for collecting, maintaining, retrieving and using advance care planning documents across settings. The program increased completion of documentation of advance care plans, achieved a high degree of consistency between patients’ desires and actual care decisions made at the end of life, and is associated with low care costs during the last two years of life.

Gundersen Health System has received national attention for Respecting Choices, and is assisting healthcare facilities around the world in implementing Respecting Choices in their communities.

More information on the Gundersen Health website:

Accepting the Award on behalf of the program are Dr. Linda Briggs and Dr. Bernard Hammes

Linda Briggs is a master’s-prepared nurse with 25 years of experience in critical care as a staff nurse, clinical nurse specialist, and educator. She received her MSN from the University of Wisconsin, Madison and an MA in bioethics from the Medical College of Wisconsin in Milwaukee. Ms. Briggs joined the Respecting Choices team as the Associate Director in 1999. In this role, she is responsible for curriculum development and provides consultation and education to assist organization and community leaders interested in implementing the nationally recognized advance care planning program, Respecting Choices. Her research has been focused on the disease-specific planning needs of patients with advanced illness and their families. Ms. Briggs has co-authored several Respecting Choices manuals and has published numerous articles related to end-of-life decision making.

Dr. Bernard Hammes is the director of Medical Humanities and Respecting Choices® for Gundersen Health System headquartered in La Crosse, Wis. In this position, he provides educational programs for house staff, medical students, nursing students and physician assistant students. He also provides in-services and workshops for the medical staff, nursing staff, social workers and the pastoral care department. Dr. Hammes chairs both the Institutional Review Board and Ethics Committee at Gundersen. He serves the role of ethics consultant on the Ethics Committee. Dr. Hammes’ work has been primarily focused on improving care for patients with serious illness. He has developed institutional policies and practices, staff education and patient/community education with a special focus on advance care planning. This work has resulted in two nationally recognized programs on advance care planning: If I Only Knew… and Respecting Choices. He served as editor for the book Having Your Own Say: Getting the Right Care When It Matters Most, which was released in 2012. He has authored or co-authored 42 articles and book chapters that are focused on clinical ethics, advance care planning and care of patients with serious illness. Dr. Hammes is a member of the executive committee of the National POLST Paradigm Task Force and serves as the current past-chair of the Task Force. He is on the board of directors for the Coalition to Transform Advanced Care (C-TAC) and serves as the vice president of the International Society of Advance Care Planning.

Select Publications:

Forbes’ “The Off-White Papers” blog by TDIA’s Craig Hatkoff & Irwin Kula – 2014

NBC News – 2012

CBS News – 2014

NPR’s “All Things Considered” Program – 2009

ABC News “Good Morning America – 2009

Angela Brugioni