"Can We Talk?": A Community-Based Training to Improve Serious Illness Communication

Area of Science:

• Healthcare communication
• Palliative care
• Quality improvement in community health

Background:

• Serious illness conversations (SICs) are frequently delayed in community healthcare settings due to clinician discomfort and inadequate training.
• Many patients prefer to die at home, but this outcome is not always achieved, highlighting a need for improved communication skills in home care and hospice.
• Structured communication training is essential to align healthcare delivery with patient and family preferences.

Purpose of the Study:

• To evaluate the effectiveness of a brief, structured, in-person training session in enhancing clinician confidence in conducting Serious Illness Conversations (SICs).
• To assess the impact of SIC training on the identification of patients eligible for palliative care.

Main Methods:

• A quality improvement project utilized a pre-test/post-test design.
• Seventy-seven community-based healthcare clinicians (nurses, therapists, social workers) participated in a 1.5-hour educational session.
• Clinician confidence was measured using the validated End-of-Life Professional Caregiver Survey (EPCS) before and after the training.

Main Results:

• Mean EPCS scores significantly increased from 2.43 (pre-training) to 2.66 (post-training) (p < .001).
• A 63% increase in the identification of palliative care bridge patients was observed following the training.
• The study analyzed 45 complete survey pairs from the 77 participants.

Conclusions:

• A brief, structured training program effectively improved clinician confidence in conducting Serious Illness Conversations.
• The training intervention led to a notable increase in the identification of patients requiring palliative care.
• Integrating SIC training into community-based organizations can catalyze practice change, establishing SICs as a standard of quality care.