What is the Serious Illness Conversation and Care Planning Program?
The Serious Illness Care Program was developed by Ariadne Labs, a joint center of Brigham and Women's Hospital and Harvard T.H. Chan School of Public Health. The program facilitates compassionate, patient-centered conversations between clinicians, seriously ill patients and their families. Drawn from best practices in palliative care, the intervention provides guidance for clinicians to initiate these difficult conversations in the right way, at the right time. Patients then have the opportunity to make informed choices that reflect their values, reduce suffering, enhance family well-being and improve quality of life. At Baylor Scott & White Health we refer to the program as the Serious Illness Conversation and Care Planning Program.
Why is Baylor Scott & White participating in the program?
Baylor Scott & White seeks to serve patients and families facing serious illness by enhancing physician communication skills and improving physician prognostic and symptom management skills. Working together with Ariadne Labs, the goal is to offer better care for seriously ill patients and their families throughout the Baylor Scott & White system, starting with a pilot population in the Central Texas region.
What is palliative care?
Palliative care, the newest board certified specialty, is an interdisciplinary team based process to relieve suffering and improve quality of life for patients and families facing serious illness. This suffering is not only physical, but also may be emotional, social and/or spiritual. It is provided at any stage of serious illness along side all other appropriate treatments for the patient's condition. Patients may or may not be considered terminally ill.
At Baylor Scott & White Health we call our palliative care service “Supportive and Palliative Care”. We say that we support patients and families facing serious illness and palliate (relieve) pain and other symptoms of serious illness. There is a heavy emphasis on communication and aligning treatment with patient values, goals and wishes so that a seriously ill person is able to live as well as possible, even if a cure is not possible.
What's involved in the program?
The program includes a system for identifying patients most likely to benefit from enhanced communication, extensive training courses and coaching for clinicians, conversation guides and patient preparation materials, suggestions to help patients discuss care preferences with family, and a system for documenting patient goals and priorities in the Baylor Scott & White electronic health record. The conversation guide addresses patient understanding of their illness, patient preferences for information, patient preferences for family involvement, personal life goals, fears and anxieties, and tradeoffs they are willing to accept.
How will this improve patient care?
Communication issues are even more prominent in the setting of serious illness that threatens one's life and alters one's view of the future. When physicians don't understand patient desires or effectively communicate with patients and families, it is a major contributor to unnecessary suffering, non-beneficial treatments that can't meet the patient's goals of care and excessive costs of treatment to patients, families, and society.
Will every Baylor Scott & White Health physician participate in training?
The training has begun with physicians who care for some of the most seriously ill patients, including oncologists, cardiologists, and geriatricians in our Central Texas region. As we learn from that experience, we will expand communication to other specialties involved in serious illness care as well as to primary care specialists – general internists and family practitioners.
How is this initiative related to population health?
This program is Baylor Scott & White's supportive and palliative care program's progression to providing patient-centered service across an entire population of patients. Palliative care is sometime seen as hospice, or as a service in the hospital only for a patient's final days. Baylor Scott & White's philosophy is that supportive and palliative care is appropriate at any age and any stage of a serious illness and that it should be available in the outpatient and even home setting. Promoting effective communication between health care professionals, patients, and families is an essential feature of specialty palliative care. With this initiative, Baylor Scott & White Health intends to enhance communication skills of primary care physicians as well as physicians who care for seriously ill patients across the entire health system.
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About Baylor Scott & White Health
As the largest not-for-profit health system in the state of Texas, Baylor Scott & White promotes the health and well-being of every individual, family and community it serves. It is committed to making quality care more accessible, convenient and affordable through its integrated delivery network, which includes the Baylor Scott & White Health Plan, Baylor Scott & White Research Institute, the Baylor Scott & White Quality Alliance and its leading digital health platform – MyBSWHealth. Through 51 hospitals and more than 1,200 access points, including flagship academic medical centers in Dallas, Fort Worth and Temple, the system offers the full continuum of care, from primary to award-winning specialty care. Founded as a Christian ministry of healing more than a century ago, Baylor Scott & White today serves more than three million Texans. For more information, visit: BSWHealth.com