Affiliations

Center for Urban Population Health

Office of Continuing Professional Development

Palliative Medicine

Presentation Notes

Poster presented at: Aurora Scientific Day; May 20, 2020; virtual webinar hosted in Milwaukee, WI.

Abstract

Background: Patients benefit when their health care providers engage in conversations about treatment options and goals of care. However, these conversations frequently do not occur. Researchers have called for new approaches to increase such conversations. The Teaching Primary Palliative Care Training program is one such approach.

Purpose: To determine whether Teaching Primary Palliative Care Training increases participant comfort engaging in goals of care conversations with seriously ill and dying patients shortly after the training and 1 year after the training.

Methods: 78 health care providers participated in Teaching Primary Palliative Care Training during the fall of 2018. Participants completed a self-assessment in which they reported on their comfort level in various circumstances related to the management of seriously ill and dying patients at baseline before the training, shortly after completing the training, and again 1 year later. We used the 1-sided sign test to assess for statistically significant improvement in self-reported comfort.

Results: At the first follow-up, self-assessments reflected significant improvement in comfort, compared to baseline, in all 5 circumstances related to the management of seriously ill and dying patients. These circumstances included: delivering bad news (P=004); discussing CPR/DNR (P=003); discussing hospice or palliative care referral (P=001); discussing artificial hydration or nutrition (eg, percutaneous endoscopic gastrostomy tubes) (P<001); and discussing prognosis specifics (P<001). At 1-year follow-up, significant improvement remained in 4 of the 5 circumstances compared to baseline: delivering bad news (P=0.010); discussing hospice or palliative care referral (P=0.006); discussing artificial hydration or nutrition (P=0.002); and discussing prognosis specifics (P=0.009).

Conclusion: In this sample, participation in the Teaching Primary Palliative Care Training program increased health care provider comfort in patient communication of various circumstances related to the management of seriously ill and dying patients. Improvements continued 1 year after the training. Next steps include determining whether increased comfort translates into changes in provider behavior such as conducting goals of care conversations with patients.

Document Type

Article

PubMed ID

33163557

DOI

10.17294/2330-0698.1818

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