Serious Illness Communication Project

Summary

The purpose of the study is to evaluate the impact of implementing a "Serious Illness Conversation Guide" to guide patient/family-clinician discussions and planning about end-of-life care decisions. The goal of the intervention is to improve achievement of patient care priorities and peacefulness at the end of life for patients with serious and life-threatening illness and their families. We hypothesize that patients whose physician is trained to use and adheres to the elements of the Serious Illness Conversation Guide will demonstrate enhanced consistency between documented key priorities and care received, and will experience greater peace in the final month of life; similarly, their families will experience higher satisfaction with care.

Conditions

• End of Life Care
• Cancer

Interventions

BEHAVIORAL

Training

1. Initial Training: The training program for clinicians randomized into the intervention arm will be 2.5 hours. The project will be introduced and the Serious Illness Conversation Guide shared. The training session will include a brief didactic session on "Challenges in discussing advance care planning/values and goals" followed by practice using the SICG. 2. Coaching and Feedback: We will also provide individual coaching for clinicians. Clinicians will be able to contact the study doctor to request coaching/debriefing on a challenging case; one of the investigators will respond within 24-48 hours for urgent or distressing cases (up to 72 hours on weekends). In-the-moment coaching will be by telephone or in person.

Sponsors & Collaborators

• Partners HealthCare

  collaborator OTHER

• Charina Endowment Fund

  collaborator UNKNOWN

• Margaret T. Morris Foundation

  collaborator OTHER

• Harvard School of Public Health (HSPH)

  collaborator OTHER

• Brigham and Women's Hospital

  collaborator OTHER

• Dana-Farber Cancer Institute

  lead OTHER

Principal Investigators

• Rachelle Bernacki, MD, MS · Dana-Farber Cancer Institute

• Atul Gawande, MD, MPH · Harvard School of Public Health (HSPH)

• Susan Block, MD · Dana-Farber Cancer Institute

Study Design

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2012-06-30

Primary Completion

2016-06-30

Completion

2016-06-30

Countries

• United States

Study Locations