The Project
In partnership with Interior Health and informed by our previous research, we are developing and piloting an implementation toolkit for a program designed to support health care teams in having more, earlier, and better Serious Illness Conversations (SICs).
This project is funded by a 2024 Michael Smith Health Research BC REACH Award.
The Need
While all BC health authorities have adopted the SICP and delivered widespread clinician education, implementation of the system change components remains inconsistent.
Even trained clinicians face systemic barriers that limit their ability to integrate SICs into everyday care.
“If your charting template doesn’t have any questions embedded in it that pertain to this [SICs], it’s really easy to not make it a priority.” (Champion’s Experience, 114)
This toolkit is designed to help health system teams identify gaps and strengths, and adapt the SICP to their unique clinical context.
Project Partners
Interior Health – Clinical pilot partner
Project Team
BC Centre for Palliative Care
Dr. Rachel Carter (Project Co-Lead)
Laura Finkler-Kemeny (Project Co-Lead)
Grace Hu (Research Coordinator)
Kathleen Yue (Project Director)
Interior Health
Vicki Kennedy (Knowledge User Co-Lead)
Shannon Paul-Jost (Knowledge User Co-Lead)
Dr. Greg Andreas (Medical Advisor)
Advisory Committee
Includes health leaders and clinicians in palliative care across BC, representing all regional health authorities and the SIC Provincial Collaborative.
The Serious Illness Conversation Program (SICP)
The Serious Illness Conversation Guide (SICG) and Program are evidence-based, patient-centred resources that support clinicians in having meaningful conversations with patients and their loved ones about values, goals, and wishes in the face of serious illness.
Research shows that implementation of the SICP:
- Promotes goal-concordant care
- Reduces anxiety and depression for patients
- Improves clinician experience in providing serious illness care
The SICP includes
Clinical Tools
- The SIC Guide (SICG): A conversation guide that offers structure, flow, and patient-tested language for clinicians.
- Adapted versions of the SICG are available for specific populations.
- Patient and family materials to support communication, preparation, and shared decision-making.
Clinician Training and Support
Several accredited training options are available to help clinicians build comfort and skill in leading SICs.
System-Level Changes
To embed SICs into routine care, system change components such as patient identification, preparation, documentation, and program evaluation are essential.
“The SIC is one of the tools that can help ensure self-determination, autonomy, and quality of life for patients with serious illness by helping them receive the care they desire.” (Champion’s Experience, 113)
The Approach
The toolkit is informed by:
- Qualitative research identifying barriers and facilitators to SICs in BC
- A provincial steering committee of SIC leads from across health authorities
- Principles of Implementation Science and Appreciative Inquiry
Key Activities & Timeline
Toolkit development & consultation
October 2024 – March 2025
Develop toolkit and gather feedback from the provincial SIC Advisory Committee.
Pilot & evaluation
Spring 2025 – Winter 2026
Pilot the toolkit across care settings in the East Kootenay region (Primary Care, Home Care, Acute Care, Long-Term Care) and collect evaluation data.
Toolkit revision
Winter 2026
Refine and update toolkit based on pilot feedback.
Provincial spread
Spring 2026
Collaborate and share the finalized toolkit across BC, with support from the Advisory Committee, and learn how it can be adapted and used across BC’s healthcare settings.
Project Products
- An SICP Implementation Toolkit, and relevant additional resources aimed for front-line clinicians, clinical educators, coordinators, and program/ACP SIC leads who can champion local implementation.
For more information
Please contact: Laura Finkler-Kemeny at lfinkler-kemeny@bc-cpc.ca.
