The U.S. faces an aging population, and more people are living longer with chronic illness. It can be challenging for patients with serious, life-threatening illnesses to make choices about the treatment they would prefer. Often, these important discussions happen too late, and occur when patients are already in crisis or when they are unable to speak for themselves. Technology-heavy end-of-life care is associated with poorer quality of life and decreased patient satisfaction, as well as anxiety and depression for family members.
Partners HealthCare, a not-for-profit health care system, recognized that less than one-third of patients with an advanced, serious illness discussed their goals and preferences with their clinicians, and that when the conversations did occur, they often took place late in the course of illness when there was little time to translate them into meaningful actions. In general, clinicians did not feel well prepared to have conversations with seriously ill patients about their goals and wishes. The organization committed to supporting patients with serious illnesses, and their families, by providing the opportunity to discuss their treatment preferences early in the course of illness, increasing the likelihood that the patient would receive the care they wanted to receive. By implementing a Serious Illness Conversation Guide, and better preparing clinicians to have serious conversations with patients, Partners achieved:
- 53 percent of patients with clinicians who used the Serious Illness Conversation Guide used hospice in the last six months of life.
- $15,588 savings in total medical expense in the last six months of life.