Communication Skills Pathfinder Gateway to the training and tools - - PowerPoint PPT Presentation
Communication Skills Pathfinder Gateway 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,
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.
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.
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
they match to treatment options
personal priorities
crisis
Patien ents d s don’t a agree. e.
How clinicians rate themselves How their patients rated them
Source: J Palliat Med 2012; 15: 418–426. 6
Had formal training Unsure of what to say
High-Need Patients
Source: National Survey Conducted by The John A. Hartford Foundation, The California Health Care Foundation (CHCF), and Cambia Health Foundation (2016)
Don’t routinely ask about goals Don’t have a place 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 communi unication d n doesn’ n’t happen a ppen at all, o
ppens v very l late i in the cour urse o se of a ser erious i illness, t ss, the he resu esult i is suf uffering, , poor outcomes es, a and p d prev even entabl ble c e costs f for
ckest p patients a and t their f families.
Source: National Survey Conducted by The John A. Hartford Foundation, The California Health Care Foundation (CHCF), and Cambia Health Foundation (2016)
Source: Harvard Business Review (Sept 2015)
clinicians to initiate these conversations
training changes clinician behavior
redesign changes clinician behavior
scales and sustains new standards of communication
Empirical evidence links communication to:
12
Communicati tion a about values es, go goals, a and c care e preferen ences i is endorsed ed b by:
Sciences
trainers
audience, level of skill, and intensity/scope of the desired intervention
across, stages, ages, diagnoses, and care settings
entities including risk-bearing organizations (e.g. ACOs), seeking to improve quality and efficiency
including inpatient settings, outpatient clinics, patient-centered medical homes, skilled nursing facilities, or home-based care.
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)
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
e Labs offers training based on a structured tool−the Serious Illness Conversation Guide−combined with a systems-change program
APC provides an online CME and CEU curriculum and Designation status in communication skills for every discipline
ital T l Talk alk offers intensive training and faculty development that enables clinicians to acquire new, sustainable, and more effective communication skills, and to avoid common pitfalls
Aria iadn dne L Labs bs—headed by Atul Gawande— launched the Ser erio ious I Illne ness C Care P e Progr gram (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
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.
systems
mmunication-skills ills-pathfinder.org