communication skills pathfinder · 2019-02-06 · our goal. the overarching goal of the pathfinder...
TRANSCRIPT
Communication Skills PathfinderGateway to the training and tools that will improve clinician communication with seriously ill patients
Our Goal
The overarching goal of the Pathfinder portal, and the new collaboration between Ariadne Labs, CAPC, and Vital Talk, is to enable every clinician to have high-quality conversations about what matters most to the seriously ill patients they serve.
We are changing the serious illness conversation
Scaling best practices in improving clinician-patient communication—for both individual clinicians and health care organizations—is a new national strategy for accelerating improvement in the care of people living with serious illness.
Why the Need
High-quality communication is the root of trust, and trust is the basis for care that achieves patients’ most important goals
Expert communication is a key driver of quality, especially for people with serious illness
Physicians, nurses, and other clinicians have had little training in communication
Communication skills are essential to care delivery that is aligned with patient and family priorities, reduced suffering, and avoidance of unnecessary and often harmful medical interventions
What Happens Now
Little upstream conversation about goals and how they match to treatment options
Focus on procedures, tests, referrals > people’s personal priorities
High-stakes decisions made under stress in times of crisis
Clinicians Think They Know How to Do This Already . . .
Patients don’t agree.
How clinicians rate themselves
How
thei
r pat
ient
s rat
ed th
em
Source: J Palliat Med 2012; 15: 418–426.6
Patients Assume Clinicians Have Been Trained To Have Conversations About Goals of Care, But…
29%46%
Had formal training
Unsure ofwhat to say
>40 million
High-Need Patients
Source: National Survey Conducted by The John A. Hartford Foundation, The California Health Care Foundation (CHCF), and Cambia Health Foundation (2016)
Though Physicians Agree That Conversations About Goals of Care Are Important . . .
71%
24%Don’t routinely ask aboutgoals
Don’t have aplace to document these conversations in the EHR 8
Source: National Survey Conducted by The John A. Hartford Foundation, The California Health Care Foundation (CHCF), and Cambia Health Foundation (2016)
If communication doesn’t happen at all, or happens very late in the course of a serious illness, the result is suffering,
poor outcomes, and preventable costs for our sickest patients and their families.
- Diane E. Meier, MD, FACP
Source: National Survey Conducted by The John A. Hartford Foundation, The California Health Care Foundation (CHCF), and Cambia Health Foundation (2016)
What Best Predicts 30-day Readmissions?
Poor communication
Source: Harvard Business Review (Sept 2015)
Patients expect clinicians to initiate these conversations
Evidence-based training changes clinician behavior
System and workflow redesign changes clinician behavior
System-wide strategy scales and sustains new standards of communication
We Know How to Fix This
Communication is the Linchpin of Quality During the Care of Serious Illness
Empirical evidence links communication to:
Improved quality of life and experience of care Better patient and family coping More goal-consistent care Fewer readmissions and hospitalizations More, earlier hospice care
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High Quality Communication is Best Practice
Communication about values, goals, and care preferences is endorsed by:
National Academy of Medicine of the National Academy of Sciences
American Society of Clinical Oncology Society of Hospital Medicine The Joint Commission American Hospital Association American Medical Association Many others…
Enter the Communication Skills Pathfinder
The One-Door Portal to Clinician Communication Skills Training
Identify your training needs
Access training and tools that fit your needs
Embed local communication skills experts and trainers
Raise the bar for quality communication organization-wide
How Does It Work?
1. Choose from a range of training options by audience, level of skill, and intensity/scope of the desired intervention
2. Implement and demonstrate training value
Who Should Use the Portal
Clinicians caring for people with serious illnessacross, stages, ages, diagnoses, and care settings
Hospitals, health systems, and payer-provider entities including risk-bearing organizations (e.g. ACOs), seeking to improve quality and efficiency of care for seriously ill patients
The portal can be adapted to any clinical setting, including inpatient settings, outpatient clinics, patient-centered medical homes, skilled nursing facilities, or home-based care.
Return onInvestment By building the capacity to improve the frequency
and quality of clinician communication with seriously ill patients, organizations can:
Improve measures of patient experience (CAHPS, likelihood to recommend scores)
Reduce readmissions
Reduce the total cost of care for patients in the last year of life
Reduce malpractice suits
Sources:Thiedke CC. What do we really know about patient satisfaction? Family Practice Management, 33-36 (2007) Pressman, H. The Cost Consequences of Unsuccessful Patient Communication (2016)Smith, S., Evidence on the cost and cost-effectiveness of palliative care: A literature review (2013)
Return onInvestment Both clinicians and organizations will improve their
ability to:
Identify high-risk patients
Ensure reliable communication about achievable priorities for care as standard of practice
Develop care plans aligned with those priorities
Follow through to align actual care with people’s informed goals over time
Different Models of Training
Ariadne Labs offers training based on a structured tool−the Serious Illness Conversation Guide−combined with a systems-change program
CAPC provides an online CME and CEU curriculum and Designation status in communication skills for every discipline
Vital Talk offers intensive training and faculty development that enables clinicians to acquire new, sustainable, and more effective communication skills, and to avoid common pitfalls
MoreAbout Us
Ariadne Labs—headed by Atul Gawande—launched the Serious Illness Care Program(SICP) in 2011. Under the leadership of Erik Fromme, MD, the SICP program provides a systems-level approach to ensuring that patients receive the care they want and experience the best possible quality of life as they live with serious illness. The program has demonstrated improvements in the frequency, timing, and quality of conversations; reductions in rates of anxiety and depression; and high acceptability among patients and clinicians.
The Center to Advance Palliative Care (CAPC) is a national organization dedicated to increasing the availability of quality palliative care services for people living with serious illness. CAPC has contributed to rapid expansion of access to palliative care in the United States. Led by MacArthur award winner Diane Meier MD, CAPC provides health care organizations with the tools, clinical training, technical assistance, and metrics needed to support the successful implementation and integration of palliative care.
VitalTalk is a non-profit organization started by Drs. Anthony Back (University of Washington), Robert Arnold (University of Pittsburgh), and James Tulsky (Dana-Farber Cancer Institute) with a mission to train clinicians caring for seriously patients and their families in the communication skills critical to elicit patient values and discuss goals of care. Based on expertise acquisition, the unique VitalTalk system enables clinicians to acquire new, more effective communication skills and to avoid common pitfalls that make them ineffective or even harmful when discussing goals of care.
Our collaboration has been made possible through generous funding by the Gordon and Betty Moore Foundation.
A new way to find communication training that’s right for you
Multiple options from trusted sources
Easy-to-follow pathways to mastery for both individuals and health systems
Find it at: communication-skills-pathfinder.org
“For the secret of the care of the patient is in caring for the patient.”- Professor Francis W. Peabody, Harvard Medical School, 1925
Thank you!