Best Practices for Teaching Clinicians to Use a Serious Illness Conversation Guide

Abstract

With the palliative care workforce shortage and changes in advance care planning reimbursement, many institutions are requesting that palliative care specialists provide serious illness communication training across their institution's workforce. Based on our experience training clinicians to use the Partners Serious Illness Conversation Guide, a structured guide to teach basic palliative care communication skills, we propose a set of best practices to help others teach use of a communication guide at their institution, including fostering a safe learning environment, explicit teaching of structured communication, and preparing cofacilitators to adapt to differing skill levels of learners.

Caring ahead: Mixed methods development of a questionnaire to measure caregiver preparedness for end-of-life with dementia

“…The Serious Illness Conversation guide for example, recommends that healthcare professionals plan ahead for serious discussions and (1) assess the person’s level of knowledge; (2) ask for permission to discuss the future/serious illness and (3) ascertain information preferences. 53 …”

“…The Serious Illness Conversation guide for example, recommends that healthcare professionals plan ahead for serious discussions and (1) assess the person's level of knowledge; (2) ask for permission to discuss the future/serious illness and (3) ascertain information preferences. 53 Insight into the language preferences of caregivers and experts related to dying was also gained from this study. Euphemisms are defined as language substitutions, replacements or social safeguards to soften words that are considered taboo or harsh.…”

Improved Serious Illness Communication May Help Mitigate Racial Disparities in Care Among Black Americans with COVID-19

“…Emphasizing patient health literacy and personal values and goals, palliative care clinicians have adapted goals-of-care communication to include language specific to symptom trajectories, treatment options, prognosis and risk assessment, advance care planning, and uncertainties associated with COVID-19-all in the context of individual patient needs. [26][27][28][29][30][31][32][33][34][35][36][37] Ariadne Labs, 26,27 Vital Talk, 28 Respecting Choices, 29 the National Hospice and Palliative Care Organization, 30 the Center to Advance Palliative Care, 31,32 and other organizations [33][34][35][36][37] offer free conversation guides, tools, and video resources designed to help clinicians lead COVID-19 care goal discussions and advance care planning across settings and languages with patients and surrogate decision-makers (Table 1).…”

“…As part of continuing education, health systems should provide clinicians with evidence-based communication tools adapted for COVID-19 and persons with serious illness [26][27][28][29][30][31][32][33][34][35][36][37] and provide training that enables effective implementation across patient populations. 50 Best practices for using communication guides to teach basic palliative care communication skills to interdisciplinary groups across primary and specialty care are freely available.…”

“…50 Best practices for using communication guides to teach basic palliative care communication skills to interdisciplinary groups across primary and specialty care are freely available. 36,51 Although palliative care communication and related tools strive to place patients and families at the center of care, there is always a potential for clinician biases to influence care quality. In addition to better training clinicians in serious illness communication, particularly as it relates to COVID-19, health systems should provide clinicians with evidence-based racial and cultural sensitivity training, implicit and explicit bias training, and resources to help reduce the effects of clinician bias on patients and families.…”