The PSST was developed and implemented by the Continuum Project ( the Serious Illness Care Program at the Massachusetts General Hospital, a large, academic affiliate of Harvard Medical School in Boston, MA. Since peer support for serious illness conversations has been shown to be valued by clinicians when it is accessible, tailored, and aligned with the clinician’s goals, 7 we developed the Peer SIC Support Team (PSST), a novel program to offer real-time assistance to frontline clinicians by leveraging trained, non-palliative care providers’ communication skills. 1, 6 However, when the pandemic arose, our providers needed additional support. This program trained non-palliative care providers how to conduct the conversation with the aid of a script. Prior to the pandemic, our hospital had trained over 1300 clinicians to conduct serious illness conversations (SIC) that explore patients’ values and priorities using Ariadne Labs’ Serious Illness Care Program. Second, insufficient anticipatory exploration of patients’ priorities may result in rushed and poorly informed decisions should they become ill. First, as is always true but especially so during times of stretched resources, it is important to avoid unwanted care. 5ĭespite these barriers, the pandemic increases the importance of understanding patients’ values and priorities. 1 During times of crisis, such as the COVID-19 pandemic, these barriers may be amplified 2– 4 as patients face uncertainty and social isolation and clinicians face changing workflows, new clinical roles, and evolving diagnostic and prognostic information. Despite the importance of understanding patients’ values and priorities, conducting conversations with patients about them commonly meets with barriers that are patient-related (e.g., anxiety or denial), clinician-related (e.g., lack of time and training), and system-related (e.g., poor end-of-life systems and methods for documenting wishes). High-quality care involves balancing treatment options that are based on the best available evidence and clinical experience with care that aligns with patients’ values and priorities.
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