About Us

Founded in La Crosse, Wisconsin, in 1991, Respecting Choices was developed as a national and international program by the Gundersen Medical Foundation starting in 1999. It now operates as a division of C-TAC Innovations. Respecting Choices helps healthcare organizations and communities to develop a culture of person-centered care by implementing care planning systems and shared decision making into the routine of care. Respecting Choices provides evidence-based education, consultation, and materials that have been implemented in over 80 communities and organizations around the world. Two decades of research findings help support the program’s value to person-centered care.

First Steps® ACP
First Steps ACP is the basic foundation for helping healthy adults and those who have not planned for their future healthcare to create an advance directive that identifies a healthcare agent and goals of care in the event of a permanent brain injury.

Next Steps ACP: "A Disease-specific Advance Care Planning Program"
Next Steps ACP is for individuals with advanced illness experiencing complications and frequent clinical encounters. This stage of planning helps individuals identify their goals of care if illness complications result in “bad outcomes” as defined by the individual.

Last Steps® ACP: "A POLST Paradigm Program"
Last Steps ACP is intended for individuals whom it would not be a surprise if they died in the next 12 months. This stage of planning helps individuals, often frail elders or those living in long-term care facilities, identify their goals of care expressed as medical orders, using the POLST paradigm program.

Shared Decision Making in Serious Illness (SDMSI)
The SDMSI program improves physicians’ and advanced practitioners’ skills in providing person-centered care through a shared decision-making process. This program is designed to help improve the skill of person-centered decision making by incorporating previous planning, an in-depth understanding of the patient’s values and goals, and aligning these with medical decisions, using a decision-making framework.

For more information about Respecting Choices programs, visit www.respectingchoices.org.

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