Updates and Innovations ECHO 2022:   Serious Illness Conversation Training for Facilitators and Clinicians 

Updates and Innovations:

An ECHO for the community of trained facilitators and clinicians for Serious Illness Conversation



April – December 2022


Members of the Hub Team:

Dr. Gillian Fyles – BC Centre for Palliative Care
Elisabeth Beddard-Huber – BC Centre for Palliative Care
Camara van Breemen – Canuck Place
Antony Porcino – BC Cancer


Goals and objectives:

To further the implementation, integration, and spread of the SIC Program into routine clinical practice throughout B.C.

The SIC Collaborative ECHO will:
1) Provide ongoing learning opportunities for those trained and championing SIC in their Health Authority or workplace
2) Increase connectedness between SIC trainers to network, support, and share resources

This ECHO series is aimed towards SIC trained health care professionals in British Columbia and Yukon including:
• Physicians
• Nurses
• Social Workers/Counsellors
• Spiritual Care Workers
• Administrators
• Allied Health
• Medical Ethicists



• Five (5) sessions
• 1:00 pm – 2:00 pm
• Sessions are one (1) hour in length with a 15–20-minute pre-recorded presentation sent to registered participants one week prior to the session
• All session materials will be available to the SIC Community of Practice


Who can attend?

Serious Illness Conversation trained facilitators, Participation will be by invitation for SIC trained facilitators or champions of SIC as invited by trained facilitators.

If you are unsure about your eligibility to register in this ECHO community of practice, please email us at echo@bc-cpc.ca for more information.


Serious Illness Care Community of Practice:

Current and Upcoming Sessions

October 20, 2022 1:00 pm
October 20, 2022 2:00 pm

Serious Illness Conversation Provincial Collaborative ECHO

Session Topic: SIC and Coaching Mentoring Strategies

Cari Borenko, BA BSW RSW MHS
Lead, Advance Care Planning

Andrew Saunderson, BSW, MSW, RSW
Social Worker, Advance Care Planning

Fraser Health Authority


The health care system and its culture is reactionary and too often downstream focused. As health care providers we are attune to identifying a problem and then finding a way to address and solve the issue. We then move onto identifying the next problem, and the cycle repeats itself. Handling one problem after another leaves us stuck in an emergent response cycle, while also overlooking upstream interventions.

In response, Fraser Health has developed and implemented a strategic systems improvement model for advance care planning and serious illness processes. This approach helps ensure efficiency while prioritizing systems change at the macro level. It embeds advance care planning and serious illness conversations into existing systems and workflows and leads to sustainable improvements. The strategy includes:
• Systems Assessment
• Education
• Recommendations and Improvement
• Coaching and Consultation
• Outcome Measuring

This interactive session will engage the audience as we explore relevant tools and resources that guide our systems work, discuss our revised education process that prioritize systems and workflow redesign, and review how we embed coaching throughout all of our work.

December 15, 2022 1:00 pm
December 15, 2022 2:00 pm

Serious Illness Conversation Provincial Collaborative ECHO

Session Topic: Making SICs bite-sized with the Two Question Challenge

Dara Lewis RN
Clinical Educator for the Regional Palliative Approach to Care Education team (RPACE)
Vancouver Coastal Health


Many patients with serious illness are receiving treatments that may not align with their wishes; in some cases, these treatments may be futile or may cause unnecessary suffering. Serious Illness Conversations can lead to less aggressive treatment decisions, fewer hospitalizations, and improved quality of life. While many health care staff recognize the benefits of engaging patients and families in these conversations, few staff feel confident or competent in having these fulsome conversations.

Staff express numerous challenges in incorporating the SIC guide into practice, even after having received the training; these challenges include the inability to remember the questions during patient encounters, lack of timely access to the guide at point of care, lack of time to engage in the conversation, and lack of routine workflows or prompts that normalize this as part of their care.

An educational exercise, entitled the Two Question Challenge, was devised at Vancouver Coastal Health (VCH) to engage the entire interdisciplinary team in asking SIC questions of their patients and families. SIC mentors supported the interdisciplinary team to choose at least two questions from a selection of nine SIC questions. They were asked to pose these questions of a patient or family member throughout their shift, and then asked to document their conversations in a centralized Goals of Care location within the patient’s chart.

Through the personal selection of the SIC questions and the ownership of just a few questions, staff gained both confidence and competence in engaging patients in these conversations. Staff felt they could remember these one or two questions for future care encounters. Both staff and patients found these conversations to be meaningful and impactful. The exercise also resulted in significantly increased goals of care documentation in the desired and centralized location within the chart.

The exercise has been trialed across seven medical and surgical units from three different acute care sites. Further applicability to non-acute settings, such as long-term care or community health units, could be explored in the future.


Past Sessions

April 21, 2022 1:00 pm
April 21, 2022 2:00 pm

Serious Illness Conversation Provincial Collaborative ECHO

Session Topic: SIC and Disenfranchised Populations: The importance of utilizing a trauma-informed, trust building approach for Serious Illness Conversations with Structurally Vulnerable/Disenfranchised Populations​​

Wallace Robinson, MSW RSW
Leader for Advance Care Planning, Providence Health Care

June 16, 2022 1:00 pm
June 16, 2022 2:00 pm

Serious Illness Conversation Provincial Collaborative ECHO

Session Topic: SIC in a Cancer Setting

Antony Porcino
BC Cancer

August 18, 2022 1:00 pm
August 18, 2022 2:00 pm

Serious Illness Conversation Provincial Collaborative ECHO

Session Topic: SIC and Cultural Safety

Nicole Wikjord, RN, MSN, CHPCN (C)
Clinical Nurse Specialist, Chronic Conditions and Serious Illness
First Nations Health Authority

Elizabeth Beddard-Huber, RN, MSN, CHPCN(C)
Clinical Lead Serious Illness Conversations,
BC Centre for Palliative Care

By the end of the session the participants will:

  • Review definitions of cultural safety and cultural humility
  • Understand why cultural safety and humility are essential to Serious Illness Conversations
  • Be aware of the SICG- adapted that was co-developed with FNHA and BCCPC
  • Understand how preparing for the SIC is important to provide culturally safer care

This ECHO will review the First Nations Health Authority definitions of cultural safety and cultural humility, to better understand why these are important to SIC.  The participants will learn about the SICG- adapted, which was co- developed with FNHA and BCCPC, based on feedback from health care providers and First Nations community members.  The adapted tool will be further explored, with emphasis on the ‘preparing’ for SIC and why this pre- conversation is important to provide culturally safer care.

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