• Briththa Seevaratnam, Samantha Wang, Rebecca Fong, Felicia Hui, Alison Callahan, Sarah Chobot, Michael F Gensheimer, Ron C Li, Duy Nguyen, Kavitha Ramchandran, Nigam H Shah, Lisa Shieh, Jack Guo-Qing Zeng, and Winifred Teuteberg.
• Department of Medicine, Stanford University School of Medicine, Stanford, California, USA.
• J Palliat Med. 2024 Jan 1; 27 (1): 838983-89.

AbstractBackground: Patients with serious illness benefit from conversations to share prognosis and explore goals and values. To address this, we implemented Ariadne Labs' Serious Illness Care Program (SICP) at Stanford Health Care. Objective: Improve quantity, timing, and quality of serious illness conversations. Methods: Initial implementation followed Ariadne Labs' SICP framework. We later incorporated a team-based approach that included nonphysician care team members. Outcomes included number of patients with documented conversations according to clinician role and practice location. Machine learning algorithms were used in some settings to identify eligible patients. Results: Ambulatory oncology and hospital medicine were our largest implementation sites, engaging 4707 and 642 unique patients in conversations, respectively. Clinicians across eight disciplines engaged in these conversations. Identified barriers that included leadership engagement, complex workflows, and patient identification. Conclusion: Several factors contributed to successful SICP implementation across clinical sites: innovative clinical workflows, machine learning based predictive algorithms, and nonphysician care team member engagement.

12 keywords...

hide…