"Can We Talk?": A Community-Based Training to Improve Serious Illness Communication.

Serious illness conversations (SICs) are often delayed or avoided in community-based healthcare due to clinician discomfort and lack of training. Given that many patients wish to die at home, yet often do not, there is a need for structured communication training in home care and hospice settings to ensure the care we provide aligns with patient and family preferences. This quality improvement project aimed to assess whether a brief, structured, in-person training session could improve clinician confidence in conducting SICs. A pre-test/post-test design was used. Clinicians participated in a 1.5-hour in-person educational session that included a PowerPoint presentation. Surveys assessing clinician confidence were administered before and after the session. Subjects included 77 clinicians: registered nurses, licensed practical nurses, physical therapists, physical therapy assistants, occupational therapists, occupational therapy assistants, and social workers. Clinician confidence was measured using the End-of-Life Professional Caregiver Survey (EPCS), a validated 28-item Likert-style survey tool. Of 77 participants, 45 complete survey pairs were analyzed. Mean EPCS scores improved significantly from 2.4329±0.3959 pre-training to 2.6593±0.2979 post-training (p < .001). A 63% increase in palliative bridge patient identification was also observed. A brief, structured SIC training significantly improved clinician confidence and increased identification of palliative care bridge patients. By embedding SIC training within a community-based organization, this work demonstrated how modest interventions can catalyze a change in practice, reinforcing the idea that SICs are a standard of quality care rather than an optional enhancement.