SERIOUS ILLNESS CONVERSATION TRAINING FOR INPATIENT MEDICAL ONCOLOGY ADVANCED PRACTICE PROVIDERS: A QUALITY IMPROVEMENT PROJECT
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Date
2021-05
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The Ohio State University
Abstract
Background Hospitalized advanced cancer patients and their families are inadequately informed about their cancer diagnosis and prognosis which limits educated reasonable decisions for their care and end-of-life planning.
Objectives The objectives of this evidenced-based project were to enhance serious illness conversations (SIC) with advanced cancer patients by providing advanced practice providers (APP) training and to increase the frequency of SIC documentation in the electronic medical record (EMR).
Methods SIC training included a 45-minute zoom recording and 30-minute discussion groups. APP beliefs and self-efficacy were measured pre-and post-training via a survey. Prior training was queried in the pre-survey. Data from APP discussion groups were using summarized and themes identified. SIC documentation frequency was measured. Pre- and post-differences were assessed Wilcoxon rank sum tests.
Findings The APP participants included 19 nurse practitioners and six physician assistants. Many APPs report little formal training, yet they are engaging in SIC regularly. Scores on both the belief and self-efficacy sections of the survey were high among APPs prior to any training and did not significantly change following training. Despite the high pre-survey scores, many of the APPs verbalized the need for more training to enhance confidence and learn communication skills. Documentation in the EMR increased following training.
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Keywords
Serious illness conversation, Advanced Practice Providers, Hospitalized Advanced Medical Oncology Patients, Goal Concordant Care, Serious Illness Conversation Training, Serious Illness Conversation Documentation