Prompting Serious Illness Conversation in Community Oncology Through Education, Shared Documentation, and Nudges

Early palliative care prompted by serious illness conversation (SIC) increases the likelihood that care aligns with patients' goals along the illness trajectory. Having sound and well-documented SIC is a cornerstone of timely palliative care. The Dana-Farber Cancer Institute has created an advance care planning (ACP) module to document and store SIC, but it is not consistently used among care team members.

This project evaluated the effectiveness of education and nudges to improve the use of the ACP module to document SIC.

ACP dashboard data measured the use of the ACP module during a three-month period after education and nudges were implemented. Thematic analysis identified reasoning for lack of engagement in SIC and how education and awareness could create a shift in this paradigm.

On review of the ACP dashboard, use of the ACP module increased across all disciplines. Survey results revealed favorable impressions about using nudges to prompt SIC.