How to Talk to Your Patients about End-of-Life Care: A Conversation Ready Toolkit for Clinicians

The ultimate goal of a "Conversation Ready" health care organization is respectful end-of-life care that is concordant with patients’ stated goals, values, and preferences.


This toolkit is intended to help clinicians address some of the challenges of engaging with patients and families in end-of-life care conversations over time.

The four cases present patients with diverse backgrounds and experiences at different points of illness, as well as diverse clinicians and care settings.

Each case describes the progression of the patient's illness and outlines key considerations for clinicians to engage the patient and family in discussions about what matters most to the patient at the end of life.

How to Cite This Document: Lally KM, McCutcheon Adams K, Zambeaux A, Joshi C, Sokol-Hessner L. How to Talk to Your Patients about End-of-Life Care: A Conversation Ready Toolkit for Clinicians. Boston: Institute for Healthcare Improvement; 2019. (Available on


IHI has learned many key lessons about taking a systems approach to improving the care of patients by ensuring that what matters most to them is expressed and respected at the end of their lives. (See the IHI White Paper, “Conversation Ready”: A Framework for Improving End-of-Life Care.)

This approach includes clinicians proactively engaging in discussions with patients and their families to understand patients’ end-of-life care wishes; reliably documenting and stewarding this information; examining their own biases around end-of-life care; and learning how to connect with patients in a culturally humble way.

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