The Checklist for Ethical and Legal Obligations (ChELO) is an innovative approach to ensure patient-centred decision-making, and supports healthcare professionals to meet ethical and legal obligations to patients at end-of-life.
The Checklist for Ethical and Legal Obligations (ChELO) is an innovative approach to ensure patient-centred decision-making, and supports healthcare professionals to meet ethical and legal obligations to patients at end-of-life.
Patients are at the heart of ChELO.
For patients – such as those living with chronic illnesses or participating in ongoing medical programs – the ChELO process helps them to:
- ask questions about end-of-life care
- identify the legally correct substitute decision maker (SDM)
- communicate and document their home language, values, wishes and beliefs.
For ICU patients, the ChELO process enables family members and substitute decision makers to reflect on and share the patient’s life, experiences, values, wishes and beliefs with the critical care team – ensuring the right care for the right patient.
The ChELO process ensures:
Decision-making is patient-centred by adhering to prior expressed values, wishes and beliefs of the patient
Communication in the home language of the patient
Patient incapacity is documented
The treatment team takes direction from the correct substitute decision maker
The SDM consents in accordance with the legislative standards
Information is documented in MediTech and/or other electronic medical record systems
Respect for the professional integrity of physicians proposing treatment plans
ChELO is a game changer.
“For families, ChELO shifts attention away from technology and back to the person they care so much about.
For nurses and physicians it protects from errors in consent and helps us to be patient advocates.
For the health care system at William Osler, in Ontario and around the world
it is the easiest way to ensure ‘the right care for the right patient.’
Instead of conflict, ChELO brings harmony.”
– Dr. Andrew Cooper
Assistant Professor, Department of Anesthesia, University of Toronto Faculty of Medicine
ChELO puts patients at the centre of decision-making.
Outcomes of Implementing ChELO in the William Osler ICU in 2015/16
%
improvement in documentation of incapacity
%
improvement in inquiries into values and beliefs
%
improvement in identification of the correct substitute decision maker
%
improvement in recording of advanced care planning documents