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• W2912446050 abstract "Background: Evidence demonstrates that discussion between clinicians and seriously ill patients about their goals and preferences, or serious illness communication, is a high-value intervention, resulting in growing demand for improvement in this area. Promising efforts address this demand utilizing interprofessional teams; yet, we lack insight into how different professions work together to deliver better serious illness communication. Objective: To explore the perceptions of primary care clinicians about interprofessional work in serious illness communication. Design: Qualitative analysis of semistructured key informant interviews. Settings/Subjects: Primary care clinicians (physicians, care coordination nurses, and social workers) who have experience implementing a structured primary palliative care program, the Serious Illness Care Program, at a large academic medical center in Boston, Massachusetts. Results: We derived primary themes and subthemes from participant descriptions of program implementation: the importance and value of interprofessional teams, nurses, and individual initiative; the role of preparation and structure in enabling high-quality communication; and the ways in which attempts to improve serious illness communication reveal other problems that can limit program effectiveness or be perceived as program failures. We derived a conceptual model that illustrates the relationships between interprofessional team interactions, workflows, and perceived program outcomes. Conclusions: This study suggests three key areas of focus for design and implementation of programs aimed at improving serious illness conversations by interprofessional primary care teams: establishing clear professional roles and responsibilities, paying special attention to interprofessional and clinician-patient relationships, and clearly structuring interventions aiming to change the way our system drives serious illness communication." @default.
• W2912446050 created "2019-02-21" @default.
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• W2912446050 date "2019-07-01" @default.
• W2912446050 modified "2023-09-23" @default.
• W2912446050 title "Interprofessional Work in Serious Illness Communication in Primary Care: A Qualitative Study" @default.
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• W2912446050 doi "https://doi.org/10.1089/jpm.2018.0471" @default.
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