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The ECHO Project

End-of-Life Decisions and Care in Hospitals

SHD 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 almost 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 four-county greater Sacramento region. Since then, 6,500 copies of these recommendations have been 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 Recommendations for Nursing Homes

Following the publication of the ECHO Community Recommendations, SHD 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 California Coalition for Compassionate Care.

For more information on these recommendations, contact SHD.

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