Prompting Serious Illness Conversation in Community Oncology Through Education, Shared Documentation, and Nudges.

BACKGROUND: Early palliative care prompted by serious illness conversation (SIC) increases the likelihood that care aligns with patients' goals along the illness trajectory. Having sound and well-documented SIC is a cornerstone of timely palliative care. The Dana-Farber Cancer Institute has created an advance care planning (ACP) module to document and store SIC, but it is not consistently used among care team members.

OBJECTIVES: This project evaluated the effectiveness of education and nudges to improve the use of the ACP module to document SIC.

METHODS: ACP dashboard data measured the use of the ACP module during a three-month period after education and nudges were implemented. Thematic analysis identified reasoning for lack of engagement in SIC and how education and awareness could create a shift in this paradigm.

FINDINGS: On review of the ACP dashboard, use of the ACP module increased across all disciplines. Survey results revealed favorable impressions about using nudges to prompt SIC.