Table 1.
Working Groups: Challenges, Aims and Methodologies
| Working Groups | CLHS Domain | The Challenge | Aims | Methods |
|---|---|---|---|---|
| Serious Illness Conversation (SIC) | Partnership for coproduction | Conversations to elicit patients’ priorities are infrequent, late and limited. | To improve frequency and documentation of SIC to improve communication about goals of care. | Clinician training and coaching; EHR documentation of SIC; QI coaching. |
| Pre-visit planning & point-of-care dashboards | Partnership for coproduction | Ineffective communication often leads to services that fail to meet the needs and goals of patients. | To build PVQ and dashboard into EHR (and integrate tools into clinical workflows) to address concerns and goals. | Design, prototype, build, and test PVQ and dashboard. Align data collection with registries. |
| Peer-facilitated support network | Patient & family support network | Care partners of people with serious illness need to cope with circumstances that arise as disease progresses and in bereavement. | To build an online peer-facilitated support network for care partners of people with serious illness and to develop a strategy to recruit local care partners. | Co-design a peer-facilitated support network with local stakeholders and enable the network with a vendor partner. |
| Collaborative learning network | Care and quality improvement network | The health system has a limited set of mechanisms to learn from excellence, test innovative practices, and drive clinical transformation. | To build a learning network where team members from different COGs come together to improve outcomes for patients and interdisciplinary teams. | Host biannual learning sessions. QI coaching to develop charters, SMART Aims, key driver diagrams, tables of measures, and show change over time. |
| Data, measurement, and scholarship | Research registry | There is no standardized measurement and reporting system to assess the progress and impact of the CLHS. | To identify a balanced set of measures; provide timely data reports to leaders and teams; and demonstrate interdisciplinary scholarship. | 78-member Delphi panel to identify measures. Align measures with strategic plans and provide monthly data reports. |
Abbreviations: COG: clinical oncology group, EHR: electronic health record, PVQ: pre-visit questionnaire, QI: quality improvement, SIC: Serious illness conversation