Loading...
Improving Documentation of Serious Illness Conversations In An Outpatient Hematology & Oncology Clinic
Gallucci, Joseph Okrant, Jessica Tarbi, Elise Burnham, Tara
Gallucci, Joseph
Okrant, Jessica
Tarbi, Elise
Burnham, Tara
Citations
Altmetric:
License
License
Abstract
Patients with cancer face complex treatment decisions, making timely, values-based serious illness conversations (SICs) essential to ensuring goal-concordant care. Despite their importance, SICs are often delayed due to clinician discomfort, limited training, and inconsistent documentation workflows. In an outpatient hematology and oncology clinic in Northern New England, SIC documentation within the electronic health record (EHR) was inconsistent and difficult to locate. This quality improvement project aimed to standardize SIC documentation by increasing use of a structured EHR documentation tool and evaluating provider perceptions of feasibility, acceptability, and workflow fit. Seventeen Advanced Practice Providers (APPs) received brief education and workflow-support materials to promote tool adoption over a two-month implementation period. SIC documentation increased from 1 update occasion in the 2 months prior to implementation (0.5 per month) to 6 update occasions during the two-month implementation period (3 per month). Post-implementation survey results demonstrated high feasibility and acceptability of the intervention, with mean aggregate Feasibility of Intervention Measure (FIM) and Acceptability of Intervention Measure (AIM) scores of 17.6/20 (SD = 1.96) and 19.4/20 (SD = 0.8), respectively. Qualitative feedback reflected improved organization of SIC content, greater accessibility of patient goals within the EHR, and benefits of the tool beyond documentation. Implementation of a structured SIC documentation tool was feasible and acceptable in this outpatient oncology setting. Low-intensity educational strategies supported uptake and may offer a scalable approach to improving accessibility of serious illness documentation and supporting goal-concordant cancer care.
Description
Date
2026-04-29
Student Status
Journal Title
Journal ISSN
Volume Title
Type of presentation
Files
Gallucci_DNP_Final_04-29-26.pdf
Adobe PDF, 3.9 MB
- Embargoed until 2027-05-01