Challenging Issues Panel
September 20th, 2019
10:15 — 11:45
Newbridge I (Simulataneous Interpretation Provided)
IMPLEMENTING SERIOUS ILLNESS CONVERSATIONS INTO CLINICAL PRACTICE: A PROMISING PRACTICE WITH PRACTICAL CHALLENGES
Carolyn Tayler, Director Strategic Initiatives, BC Centre for Palliative Care
- Elizabeth Beddard Huber, Clinical Lead Serious Illness Conversations, BC Centre for Palliative Care;
- Dr. Harvey Chang, Palliative Care Physician, Jewish General Hospital, McGill University
- Jocelyn Semenchuk, Nurse Clinician, Alberta Health Service
Serious Illness Conversations are clinician lead discussions between seriously ill persons and health care providers that include person tailored information about disease understanding, prognosis, goals, fears, worries, strengths, critical abilities and tradeoffs (Bernacki & Block, 2014). The Ariadne Labs (Harvard Medical School) Serious Illness Care (SIC) Program is a widely adopted, evidence-based system-level approach that supports the use of a structured tool to guide conversations. All too often, conversations about goals and values are left until the final months of life or are put off completely due to prognostic uncertainty (Bernacki & Block, 2014). The challenge is to have Serious Illness Conversations early enough for the person to have the time, ability and awareness of their illness to be able to enact their personal goals. Initiatives have taken place in BC, Alberta and Ontario to implement serious illness conversation training into a variety of clinical practice and educational settings.
Barriers to having SIC earlier have been identified as patient identification, prognostication, timing and role clarity. Our panel will share their experiences as clinicians and educators in overcoming these challenges.
- Recognize triggers that identify high-risk patients who would benefit from a Serious Illness Conversation.
- Understand the Interprofessional Roles in having Serious Illness Conversations
- Explore the difficulty in having a prognostic discussion.
- Gain insight into how to integrate conversations into various clinical practice settings