Goals of Care Conversations at the End-of-Life: Perceived Impact of an Interprofessional Training Session on Professional Practices

Abstract

An interprofessional training session for health professionals was designed to optimize practice regarding goals of care at the end-of-life with patients and their families. The training session supported implementation of a new unified format, used in all healthcare establishments in Quebec since 2018, to document treatment preferences of persons with serious illness or advanced frailty. Three months after the training, participants revealed three main changes in their professional practices: (1) better use of the unified form as a communication tool to discuss end-of-life care with patients; (2) improved interprofessional practices in complex goals of care conversations situations through better affirmation of their role along with recognition of other professionals' roles in this decision-making process; and (3) assumption improved recognition of advocacy, support and enabler roles with patients and families during goals of care conversations. Change facilitators are related to the participants' personal characteristics, whereas the change constraints identified by participants mainly concern organizational factors. This implies potential recommendations to optimize patients' ability to mobilize in order to make informed decisions about their end-of-life care.