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Improving communication for families through palliative care training

Thanks to donor support, the innovative palliative care team based at Providence St. Peter Hospital will begin filming a series of videos to help create a library of high-quality educational videos.

Designed primarily for staff, the videos will teach techniques for holding conversations with patients who are seriously ill - and their families - about what their goals are, navigating ethically and emotionally challenging situations, and supporting patients and families with the stresses of incurable illness.

Palliative care is specialized medical care for people with serious illnesses. Dr. Gregg VandeKieft, medical director for St. Peter Hospital’s palliative care program says, “We focus on providing relief from the symptoms, pain, and stress of a serious illness - whatever the diagnosis.”

Dr. Sarah Merrifield will be leading the production of videos over the next year. The project will start initially for Critical Care staff, building on a collaboration that began in 2013. She says, “If successful, this model could be used to create a library of palliative care education for providers and staff in many settings.”

Often, patients express a desire to forego invasive tests and treatment, especially towards the end of life. However, these desires are not always shared with their families, making for difficult conversations. Sometimes there is uncertainty about the prognosis or the expected benefits of various interventions, adding complexity to the decision making process.  Good palliative care isn't always about shifting the focus of care towards less burdensome treatments. Dr. Merrifield explains, "We aim to clarify treatments that best help a patient achieve their goals. Sometimes staff benefits from strategies and support in caring for patients and families who make choices that differ from what they themselves might choose."

Having clinicians trained in helping patients and their families with challenging decisions better serves the patient and can avoid unwanted treatments in many cases. Dr. Merrifield says the effectiveness of the video format will be measured, and that, "Some patients we now see in the critical care unit--those who prefer to avoid intensive care in their last days, weeks, or months of life-- may receive care more in keeping with their hopes and goals." She says, "We also hope that the video training will lead to an added layer of support for families and reduce stress and burnout of staff."

The program is one of many funded by Providence St. Peter Foundation through donor support.