The PACT Project: Feasibility of a Multidisciplinary, Multi-Faceted Intervention to Promote Goals of Care Conversations

Eytan Szmuilowicz*, Rebecca K. Clepp, Jayson Neagle, Adeboye Ogunseitan, Martha Twaddle, Gordon J. Wood

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Patients living with serious illness generally want their physicians to facilitate Goals of Care conversations (GoCc), yet physicians may lack time and skills to engage in these conversations in the outpatient setting. The problem may be addressed by supporting multiple members of the clinical team to facilitate GoCc with the patient while admitted to the hospital. Methods: A multi-modal training and mentored implementation program was developed. A group of 10 hospitals were recruited to participate. Each hospital selected a primary inpatient unit on which to start the intervention, then expanded to a secondary unit later in the project. The number of trained facilitators (champions) and the number of documented GoCc were tracked over time. Results: Nine of 10 hospitals completed the 3-year project. Most of the units were general medical-surgical units. Forty-eight champions were trained at the kick-off conference, attended primarily by nurses, physicians, and social workers. By the end of the project, 153 champions had been trained. A total of 51 087 patients were admitted to PACT units with 85.4% being screened for eligibility. Of the patients who were eligible, over 68% had documented GoCc. Conclusion: A multifaceted quality improvement intervention focused on serious illness communication skills can support a diverse clinical workforce to facilitate inpatient GoCc over time.

Original languageEnglish (US)
Pages (from-to)355-362
Number of pages8
JournalAmerican Journal of Hospice and Palliative Medicine
Volume41
Issue number4
DOIs
StatePublished - Apr 2024

Keywords

  • communication skills training
  • goals of care conversations
  • quality improvement
  • system change
  • team-based care

ASJC Scopus subject areas

  • General Medicine

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