Serious Illness Conversations
Project Overview
Aims: By Nov 30, 2025,
- Attain a 2% increase in Provider Orders for Life Sustaining Treatment ( POLST ) completion
- Increase usage of the Serious Illness Conversation Guide (SICG) SmartForm by 2%
- Increase Medicare Billing for Advance Care Planning by 2%
Project Description
This Continuing Certification (MOC) improvement project provides MOC credit to clinicians for efforts to improve confidence in holding Serious Illness Conversations and to increase completion of appropriate documentation resulting in:
- Increased advance directives in the EMR
- Increased number of clinicians having SIC conversations with patients
- Early hospices admissions
- Early palliative care consultation
- Improved clinical outcomes
Meaningful Participation Requirements
- Identify and/or acknowledge a gap(s) in outcomes or in care delivery.
- Participate and/or review required education.
- Review personal data and patient lists as available.
- Implement improvement strategies for a minimum of 3 months assessing barriers and identifying solutions.
- Discuss project status with colleagues/leadership as able.
Participation Attestation
To receive Continuing Certification (MOC) credit, clinicians must demonstrate meaningful participation in the improvement project including taking an active role in the project requirements as designated by the project leader.
- Reflect on outcomes to determine whether strategies resulted in improvement and if not, barriers encountered.
- Attest to meeting the above requirements.
Credit
This improvement project meets the following medical boards’ physician MOC Part IV requirements and NCCPA’s CME credit:
- Family Medicine (ABFM): Performance Improvement Activity (20 Points)
- Internal Medicine (ABIM): Practice Assessment (30 Points)
- Emergency Medicine (ABEM): One Practice Improvement (PI) Activity
- NCCPA: 30 PI - CME Credits
Target Audience
Primary Care clinicians
Learning Objectives
By the end of the project clinicians will:
- Define the differences between a POLST form and Health Care Directive
- Analyze which patients would benefit from a serious illness conversation
- Adopt asking What Matters Most and documenting using the WMM note type
- Adopt using the Serious Illness Conversation Guide in personal practice and document in the SICG SmartForm
Planning Team
Terry Maag, MD
Division Medical Director
HealthPartners Home and Community Services
Vic Sandler, MD
Geriatrician, Hospice and Palliative Medicine Specialist
HealthPartners Hospice
Michelle Cotter
Program Manager, Advance Care Planning
HealthPartners
Ann Tarnowski
Program Manager, Continuing Certification (MOC)
Park Nicollet
This project is intended for our internal audience only. A login using the HealthPartners Login with your network credentials is required to register.
NOTE: Separate from submitting this registration in CMEcentral, you are required to complete one of the options from this grid at the start of the project. Some options require additional registration on an external site. You will be reminded of this again on the next page.
Do not close out of CMEcentral until you have registered for one of the three required education options and have submitted a response to the Starting Confidence question.
If you are already registered for this project, click Start to continue.
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Internal Audience applies to all HealthPartners Employees and Contract Staff, including HealthPartners, Park Nicollet, TRIA, Westfields Hospital, HPCMC, Hudson Hospital, PNBConline.Com, Lakeview Hospital and Clinics, Amery Medical, HutchHealth