It can be equally difficult for health care providers to raise the topic with patients and their families. To remove this barrier, a new project at Hamilton General Hospital (HGH) is looking to empower clinicians with the skills they need to ask the right questions.
According to Dr. John You, a doctor in the department of medicine who is leading the project, this problem has deep roots in the health sector.
“The modern health care system as a whole has tended to focus on diseases and not people,” he says. “Doctors and clinical staff are trained to diagnose an illness, develop a treatment plan and get them on the road to recovery. Historically, the focus of training is much more about treating the illnesses, not the patients.”
PUTTING RESEARCH INTO PRACTICE
Dr. You is a leading thinker in the area of end-of-life communication and decision making. His research has found that a disconnect exists between patients’ end-of-life goals and the care that they actually receive. In 2014, he published a collaborative national study which involved almost 450 patients and family members looking at end-of-life communication. Health care providers should discuss 11 key elements with a patient regarding their end-of-life care, but the study showed that on average, only 1.4 were raised. This can negatively impact a patient and family’s satisfaction with their experience.
Dr. You turned these insights into action and launched the Serious Illness Care Program communication training pilot at HGH. Based on collaboration with colleagues at Harvard University, the program empowers clinical staff with the skills, knowledge and confidence to connect with patients about their goals of care. The pilot, which launched in late February, is running in three medical units at the hospital, and physicians have been receiving the situation-based skills training.
“By training physicians to take the time to ask the important questions, we hope to encourage more, earlier and better communication between a patient and their care team. Honest and open communication builds trust and, ultimately, it empowers patients to advocate for themselves about what really matters to them in the end,” says Dr. You.
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