COVID-19 Conversations: Talking to Patients at High Risk

By initiating conversations early — before patients become ill — clinicians can help ensure that the values and priorities of the patient are central to COVID-19 treatment decisions.

Communicating with patients about serious illness is difficult under the best of circumstances. The COVID-19 pandemic presents challenges that make these conversations even more difficult, but perhaps more important than ever, particularly for patients who are at highest risk of developing severe complications if they do become sick.

Clinicians have a critical role to play in helping patients understand the potential impact of COVID-19 on their health. They can also help ensure that people in their patient’s support system understand their values, priorities, and goals, and are prepared to make informed decisions should the patient be unable to make them independently.

To support clinicians in having difficult conversations with patients at high risk for serious complications of COVID-19, Ariadne Labs has developed the Serious Illness Care Program’s COVID-19 Response Toolkit.

The toolkit is anchored by the COVID-19 Conversation Guide for Outpatient Care. The guide will help clinicians engage in compassionate conversations with high-risk patients about how they can best protect themselves and help them understand what matters most to each patient in the context of COVID-19. It also prepares clinicians to acknowledge and respond to emotions during difficult, uncertain times and make recommendations about next steps.

The toolkit also contains resources to support effective use of the written guide, including a brief video demonstration, tips for having serious illness conversations virtually, counsel on making medical recommendations based on the patient’s wishes, and a customizable resource guide to help clinicians connect patients with needed support services.

A conversation guide specific to inpatient care settings will be added to the toolkit in the coming days.