We know that seriously ill patients who have conversations with their clinicians about their goals and wishes are more likely to have better outcomes fewer non-beneficial medical interventions, and better quality of life. Yet less than one third of patients with end-stage medical diagnoses report discussing their care goals and preferences with their clinicians. In fact, a survey of Massachusetts residents released by the Massachusetts Coalition for Serious Illness Care found that although 96 percent of respondents believed that discussing end-of-life care plans is important, only 10 percent have done so with their health-care provider and health care agent.

There are several barriers that make having conversations difficult across care settings:

  • Time constraints
  • Lack of the necessary skills and confidence among clinicians
  • Fear among clinicians that bringing up serious illness and end-of-life issues may be harmful to patients.
  • Uncertainty among clinicians about when it is appropriate to have these conversations
  • Confusion about who should initiate the discussion
  • Lack of systems to implement conversations and ensure quality and control
  • Shortage of palliative care specialists

The Serious Illness Care Program’s research is focused on how to address these barriers and best support non-palliative care clinicians to engage in these conversations with their seriously ill patients.

Effect of the Serious Illness Care Program on expenses at the end of life
Training Clinicians in Serious Illness Communication Using a Structured Guide
Effect of the Serious Illness Care Program in Outpatient Oncology
Testing the Serious Illness Care Program at the Dana-Farber Cancer Institute
How to Improve Advanced Care Planning for African Americans
Serious illness care in the primary care setting
Brigham and Women’s Faulkner Hospital/DCI Dialysis Unit
Serious illness care for chronic critical Illness settings
Serious illness care in emergency surgery settings
Serious Illness Care in African-American Patients and Families