{"entity":{"id":"idea-acc-serious-illness-conversation-prompts","kind":"idea","name":"Train every oncology team in serious-illness conversations and prompt them in the record","aka":[],"tldr":"Patients with advanced cancer often never have a clear conversation about what to expect and what matters to them. A structured conversation guide, taught to clinicians and prompted by the record, makes these talks happen earlier.","summary":"The Serious Illness Care Program (Ariadne Labs) combines clinician training in a structured conversation guide with electronic prompts and documentation. A cluster-randomised trial in oncology showed earlier, more frequent, and more patient-centred conversations and reduced anxiety and depression. Adoption remains limited. Making the programme a standard component of oncology practice would improve goal-concordant care at low cost.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Pain relief and palliative care are unavailable to most): WHO fact sheet, Palliative care","url":"https://www.who.int/news-room/fact-sheets/detail/palliative-care"}],"tags":[],"related":[],"cancers":[],"sections":["supportive-care"],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-palliative","b-patient-voice"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Systematic implementation will raise the proportion of patients with advanced cancer who have a documented goals-of-care conversation before their last month of life from under 40% to above 80%, and reduce non-beneficial intensive care at end of life.","rationale":"Trial evidence exists; the intervention is training and prompts, which scale cheaply.","test":"A stepped implementation across a health system with conversation documentation timing, end-of-life care intensity, and bereaved family ratings as endpoints.","maturity":"being-tested-at-scale","actor":"clinic","cost":"small","horizonYears":2},"route":"/ideas/idea-acc-serious-illness-conversation-prompts/","neighbours":{"section":[{"id":"supportive-care","kind":"section","name":"Supportive Care & Survivorship","route":"/fronts/supportive-care/"}],"bottleneck":[{"id":"b-palliative","kind":"bottleneck","name":"Pain relief and palliative care are unavailable to most","route":"/bottlenecks/b-palliative/"},{"id":"b-patient-voice","kind":"bottleneck","name":"Patients lack understanding, navigation and agency","route":"/bottlenecks/b-patient-voice/"}]}}