{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T15:26:14Z","timestamp":1787153174041,"version":"build-2736575974"},"reference-count":32,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Allina Health Foundation","award":["25-0018"],"award-info":[{"award-number":["25-0018"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Palliative Medicine"],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Serious illness conversation (SIC) is a structured conversation framework designed to improve shared decision making and promote goal-concordant care with patients anticipating end-of-life care decisions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Examine reach, timeliness, and quality of SIC implementation across a health system after implementation of a SIC Program (SICP). Examine factors associated with SIC completion for eligible patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective observational cohort study of decedents eligible for SIC from 2022 to 2024 in a large health system in the United States.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements:<\/jats:title>\n                    <jats:p>Proportion of eligible patients with a documented SIC, demographic and clinical characteristics, timing of SIC relative to eligibility and death, number, and quality of SIC sessions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>About 7424 patients met the inclusion criteria, and half (49.5%) of those had SIC documentation. Of those, mean number of SICs was 3.6 (SD 5.56). First documented SIC included defined quality components 31.1% of the time. Factors associated with SIC included palliative care visits (OR 2.26, 95% CI 1.84, 2.78), a primary care provider in the system (OR 1.77, 95% CI 1.59, 1.96), and an inpatient admission with discharge to home care (OR 2.36, 95% CI 2.07, 2.70). Patients with dementia (OR 0.58, 95% CI 0.51, 0.66) were less likely to have SIC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Systemwide implementation of an SICP engaged half of eligible patients; many of those had multiple documented conversations prior to death. More work is needed to engage eligible patients, especially those with dementia, and to improve conversation quality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10966218261451668","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T09:32:24Z","timestamp":1780392744000},"page":"1251-1261","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Implementation of a Serious Illness Conversation Program in a Health System: A Retrospective Observational Study"],"prefix":"10.1177","volume":"29","author":[{"given":"Glen","family":"Varns","sequence":"first","affiliation":[{"name":"Department of Palliative Care, Alina Health, Minneapolis, Minnesota, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5852-3539","authenticated-orcid":false,"given":"Abbey","family":"Sidebottom","sequence":"additional","affiliation":[{"name":"Care Delivery Research, Allina Health, Minneapolis, Minnesota, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katy","family":"Hentges","sequence":"additional","affiliation":[{"name":"Department of Palliative Care, Alina Health, Minneapolis, Minnesota, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Castro-Pearson","sequence":"additional","affiliation":[{"name":"Clinical Research Informatics and Analytics, Allina Health, Minneapolis, Minnesota, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Richardson","sequence":"additional","affiliation":[{"name":"Independent Consultant, Minneapolis, Minnesota."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Downing","sequence":"additional","affiliation":[{"name":"Department of Population Health, Allina Health, Minneapolis, Minnesota, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,2]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2017.0548"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.207624"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-131-2-199907200-00006"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2014-205365"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-684X-12-7"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2017.0374"},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-156-3-201202070-00008"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2016.3212"},{"key":"e_1_3_2_10_1","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2017.0451"},{"key":"e_1_3_2_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2018.05.016"},{"key":"e_1_3_2_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2014.8425"},{"key":"e_1_3_2_13_1","volume-title":"Dying in America: Improving Quality and Honoring Individual Preferences near the End of Life","author":"Institute of Medicine","year":"2015","unstructured":"12.Institute of Medicine. 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