This white paper proposes a Serious Illness Program Design and Implementation Framework (SIP Framework) to inform program development, replication, and scaling across a broad range of serious illness populations and settings. The SIP Framework process begins with setting a vision and completing a local needs assessment and walks through a range of evidence-based options for each facet of care model design and implementation, including possible business models, target populations, services, and outcomes to guide health care organizations in adapting serious illness programs to their local contexts. Key implementation considerations for encouraging program success include leveraging existing programs and resources, recruiting strong program leaders, engaging staff, assembling experienced multidisciplinary care teams, building strong relationships among team members and with patients/caregivers, and establishing processes for program evaluation and continuous quality improvement.
The SIP Framework reflects a growing landscape of care models for serious illness, distilling existing evidence from a wide range of existing programs to offer a variety of promising approaches to program implementation. Next steps in this work include framework impact assessment, piloting the framework for use with future programs, monitoring and reporting program implementation, creating a simulator for serious illness program payment models, and identifying and implementing research and policies aimed at promoting the implementation of a serious illness program.
