The Project
Informed by our previous research , we are partnering with Interior Health to develop and pilot an implementation toolkit to support health care teams in having more, earlier and better Serious Illness Conversations (SICs).
This project is funded through a 2024 Michael Smith Health Research BC REACH Award.
The Serious Illness Conversation Program
The SIC Guide and Program are validated, patient-centred resources to facilitate clinicians in having conversations with people and their loved ones about their preferences, goals and wishes in the face of a serious illness. Implementation of the SIC Program (SICP) has been demonstrated to promote goal concordant care, reduce patient depression/anxiety and improve clinician experience in caring for people with a serious illness.
The SIC Program includes:
1. Clinical Tools
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- The SIC Guide (SICG) – an evidence-based tool that provides support for clinicians around the conversation flow and order, including providing patient-tested language.
- Patient/family materials
2. Clinician Training/Support
3. System Changes, including:
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- Patient identification
- Patient preparation
- Documentation
- Program evaluation
Partner
Interior Health
Project Team
BC Centre for Palliative Care:
- Rachel Carter (Researcher Co-lead)
- Laura Finkler-Kemeny
- Grace Hu
- Kathleen Yue
Interior Health:
- Vicki Kennedy (Knowledge User Co-Lead, CNS, Interior Health)
- Shannon Paul-Jost (CNS, Interior Health)
- Dr. Greg Andreas (Medical Lead, Interior Health)
Advisory Committee
This committee includes representatives from BC’s Health Authorities and SIC Provincial Collaborative, including health leaders and clinicians in palliative care across BC.
For more information
Contact Laura Finkler Kemeny at lfinkler-kemeny@bc-cpc.ca
The Need
While all health authorities in BC have adopted the SICP and conducted extensive clinician training and education, there are some gaps in the implementation of the system changes components of the program.
Our aim is for the implementation toolkit to help those in the health system address these gaps and improve their implementation of the SICP. The toolkit provides a flexible approach to guide each unique clinical setting based on their current state of implementation.
The Approach
The toolkit is informed by research identifying the key barriers and facilitators clinicians encounter when having SICs in practice in BC, and by a steering committee including SIC leads from across the province. The toolkit draws on principles of Implementation Science and Appreciative Inquiry.
Key Activities
Toolkit Development & Research User Consultation
Oct 2024 – March 2025
Develop toolkit based on previous research, consult with advisory committee comprising of SIC leads across BC to get feedback on toolkit components.
Toolkit Piloting & Evaluation
Spring-Summer 2025
Pilot toolkit within a community in East Kootenay region within Interior Health , across various care settings including Primary Care, Home Care, Acute Care and Long Term Care. Collect evaluation data from pilot sites relating to the use of the toolkit.
Toolkit Revision
August-September 2025
Update toolkit according to evaluation data and feedback from pilot sites.
Provincial Toolkit Dissemination
Fall 2025
Spread toolkit provincially with assistance of advisory committee.
Studies
Integrative Review – Implementing Serious Illness Conversations– coming soon October 2025
Champion’s Experience Qualitative Study – coming soon December 2025
Trained Clinician’s Experience of having SICs in regular practice: A Mixed Methods Study – coming soon December 2025
Finalized SIC Implementation Toolkit – coming soon December 2025
