"Conversation Ready": A Framework for Improving End-of-Life Care

Conversation Ready white paper

How to Cite This Paper:

McCutcheon Adams K, Kabcenell A, Little K, Sokol-Hessner L. “Conversation Ready”: A Framework for Improving End-of-Life Care. IHI White Paper. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2015. (Available at ihi.org)


In 2012, The Conversation Project, in collaboration with the Institute for Healthcare Improvement, launched a public campaign to encourage people to "have the conversation" about their wishes for end-of-life care with loved ones, with the aim that everyone’s wishes are expressed and respected. As the campaign grew, it became clear that health care organizations would need to be “ready” — that is, to have systems in place to receive patients’ wishes, to record them in the health record, and to respect them by providing care aligned with patients’ stated wishes.

Thus, IHI’s “Conversation Ready” work began in 2012 with the aim of developing reliable processes for health care organizations to engage patients in conversations about their wishes for end-of-life care, steward that information, and then respect those wishes at the appropriate time.

Based on this work, IHI developed a detailed framework built on five core principles to help organizations begin the process of becoming Conversation Ready. This white paper describes the Conversation Ready framework, the changes associated with the framework’s five principles that can be implemented to improve end-of-life care, examples of changes tested by organizations, and suggested measures to guide improvement.​

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In this video, white paper co-author Dr. Lauge Sokol-Hessner talks about what organizations and providers need to do to become "Conversation Ready."​​
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