Events for Health-Care Professionals

The team at BCCPC has gathered links to education events designed for Health Care Providers caring for people affected by life-limiting illness. The events are not created or endorsed by BCCPC unless stated in the description.

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Making SICs bite-sized with the Two Question Challenge

December 15, 2022 @ 1:00 pm - 2:00 pm PST

Logo of Project ECHO, Pallium Canada & BCCPCSerious Illness Conversation Provincial Collaborative ECHO

Presenter: 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.



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