Abstract| Volume 61, ISSUE 3, P670, March 2021

Improving Provider Training for Implementing a Comfort Care Order Set in Veterans Affairs Medical Centers (VAMC): Palliative Care Consult Team Members’ Perspectives (SCI902)


      • 1.
        Articulate PCCT members’ perspective on improving provider training for implementing a Comfort Care Order Set (CCOS) in Veterans Affairs Medical Centers (VAMC).
      • 2.
        Engage in a discussion of potential mechanisms for implementing CCOS training as a process incorporating both pre-and post-training elements to enhance training readiness, relevance, and continuity.


      Best Practices for End-of-Life Care for our Nation’s Veterans (BEACON II) delivered a Comfort Care Education Intervention leveraging the established infrastructure of VA Palliative Care Consult Teams (PCCT) to facilitate activation of a Comfort Care Order Set (CCOS) and education of non-palliative providers in primary palliative care in acute care. During the 4-month implementation window, PCCTs were charged with training providers and developing plans to sustain training.

      Research Objectives

      To explore PCCT members’ perspectives on the CCOS training process.


      132 PCCT members from 46 VAMCs received training in the CCOS. 78 individuals participated in post-training telephone interviews and were asked to provide a subjective assessment of the training experience and offer suggestions for improvement. Qualitative analysis identified key strategies for improving training.


      The overarching theme was the importance of creating and sustaining momentum across the training continuum. Key elements were 1) setting the stage prior to training by aligning trainees’ understanding of the implementation process with their goals and facilitating site readiness for CCOS installation, uptake, and utilization; 2) enhancing relevance by decentralizing training and customizing it to trainees’ needs, service line issues, and facility characteristics; and 3) systematizing post-training implementation support by incorporating a robust follow-up process for ongoing trainee-trainer communication; and 4) fostering trainee networking to develop a repository for shared discourse about best practices.


      Improving PCCT training for implementing a CCOS requires moving beyond a one-and-done paradigm and embracing a comprehensive approach, which views training as a continuum that generates pre-training clarity and readiness, ensures training relevance, and facilitates post-training follow-up and networking.

      Implications for Research, Policy, or Practice

      Recognition of the need for palliative care across a variety of inpatient settings calls for innovative training strategies to support primary palliative care. Seeking input from PCCTs about improving CCOS training is pivotal for promoting best practices.