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Serious Illness Conversations

** This session earns SW, RN and CCM Ethics **
This session provides an introduction to Serious Illness Conversations with emphasis on key communication skills and use of evidence based Structured Communication Guides for nurses and social workers to facilitate Serious Illness Conversations. Serious Illness (SI) Conversations, often-called Goals of Care Conversations (GOC), focus on engaging in conversations with individuals with a serious illness (expected life expectancy of 1-2 years) to determine goals, values and preferences that then inform the treatment plan of care.

Both the 1997 and 2015 Institute of Medicine reports about death and dying in America identified significant opportunities for improved communication with patients and families about their preferences for end of life care. These reports suggested that clinician education and training did not provide them with the knowledge, skills and confidence to address the physical and emotional needs and concerns that dying patients and families frequently experience. Further, failure to explore and address patient and family preferences resulted in an end of life experience that was not in accordance with their values and goals.

Research has demonstrated that earlier conversations with patients about their goals and priorities as they live with serious illness (SI) are associated with enhanced goal concordance, improved quality of life, reduced suffering, better patient and family coping, higher patient satisfaction and less non-beneficial care and costs.

Nurse and social worker case managers are uniquely positioned to initiate these conversations. This session provides examples of how health care professionals utilize key communication skills and an evidence based structured communication guide to facilitate the conversation while following the Code of Professional Conduct for Case Managers. Ultimately, this knowledge provides case managers with a unique opportunity to collaborate with the health care team to align the patient stated goals and preference for care with the actual care they receive.

  1. Describe the relationship between Serious Illness conversations and case management and goals of care discussions with respect to the rights and inherent dignity of all clients.
  2. Describe the role of the social worker and nurse in eliciting a patient's goals, preferences and values to inform the plan of care.
  3. Identify three communication skills to be most applicable to SI conversations and describe the differences between the medical model and the biopsychosocial model as it related to Serious Illness Conversations.