JL533. Utilizing the COMFORT Curriculum With Advanced Practice Providers to Enhance the Family Meeting Process and Improve Patient Care
Anne M. Kolenic, MSN, RN, AOCNS®, and Linda K. Baer, MSN, NP-C, AOCNP®; University Hospitals Seidman Cancer Center, Cleveland, Ohio
© 2018 Harborside™
JADPRO Live at APSHO 2017
Marriott Marquis, Houston, Texas • November 2–5, 2017
The posters for the abstracts below can be found at:
Purpose: To implement and evaluate an educational program for advanced practice providers (APP) utilizing the COMFORT Curriculum.
Background: The Institute of Medicine (IOM) has identified the need to address gaps in care of critically ill and dying as essential for ensuring a sustainable health care system. Strong communication skills have emerged from the IOM report as a central theme for improving care. Although cancer APPs are well positioned to hold goals of care (GOC) conversations and conduct family meetings, they often lack the communication skills, knowledge of, and confidence to do so. The COMFORT Communication Curriculum is a national health communication curriculum for oncology healthcare professionals. The aim of this project was to implement a training program focused on communication skills for GOC conversations and conducting family meetings.
Intervention: A two-part educational series was implemented by APPs trained in COMFORT curriculum. Based on findings from a learning needs assessment, the Communication, Family Caregivers, and Team modules were utilized. Each session was 50 minutes long and comprised of didactic information provided from COMFORT materials, case studies, and modeling of skills. The second session also provided a plan for standard documentation and billing options for GOC conversations. Outcome
Measures: The program evaluation assessed participation, knowledge, and confidence. Fifty-one APPs attended session one, while only 33 returned for part two due to clinical responsibilities. Overall, 54% of APPs attended both. Participants completed evaluations upon completion of each session. The initial outcomes reported were that 98% of participants responded they had gained knowledge and stated they would implement skills into clinical practice. Surveys will be sent at 2 and 6 weeks post training to assess intermediate outcomes for knowledge and confidence in performing skills, conducting family meetings, and engaging in GOC conversations. Results of these two time points will be available in September.
Summary: APPs responded positively to the educational content of both sessions and have anecdotally reported use of the skills in practice. Preliminary data has been shared with Senior Leaders who support dissemination of the education, tools, and documentation plan to interdisciplinary disease teams.
Discussion: Utilizing the COMFORT curriculum was feasible and enabled standardized content in communication and the process of family meetings to be presented to APPs. By educating these providers and enabling them with skills and tools to engage in GOC conversations, we anticipate greater transparency in the goals and wishes of our patients as they move within inpatient and outpatient settings.
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