Implementing the Serious Illness Care Program in Primary Care

Area of Science:

• Healthcare Systems
• Primary Care Medicine
• Patient Communication

Background:

• Inadequate communication regarding serious illness care preferences presents challenges for patients, families, providers, and healthcare systems.
• Numerous patient- and system-level barriers impede comprehensive serious illness communication.

Purpose of the Study:

• To implement and evaluate a structured approach within a primary care clinic to facilitate serious illness care preference conversations.
• The structure aimed to be adaptable to clinic workflow, improve provider perceptions, enhance documentation, and ensure a positive patient experience.

Main Methods:

• Utilized the Johns Hopkins Nursing Evidence-Based Practice model and the Serious Illness Care Program.
• Interventions included provider/staff training, identification of high-risk patients, system integration, and outcome evaluation.
• A 5-week pilot practice change was conducted following provider training.

Main Results:

• Provider perceptions of care conversations were positive post-implementation.
• Three serious illness care conversations were initiated during the pilot phase.
• Additional patients were prepared for future conversations using informational tools.

Conclusions:

• The implemented structure facilitated serious illness care conversations in a primary care setting.
• The project demonstrated positive provider perceptions and improved readiness for future discussions.
• This evidence-based approach addresses barriers to effective serious illness communication.