A growing number of organizations understand that the traditional health care system is not working for frail older adults and others with serious illness—and are doing something about it. These innovators can use CAPC courses and resources to train their staff in the impactful skills that prevent crises, optimize quality of life for patients and families, and ensure cost-effectiveness.

Disruptor organizations can build skills and capabilities in palliative and geriatric care to achieve strong outcomes.

What’s in the Toolkit

Use these tools to uncover the risks and sources of suffering that drive avoidable utilization.

Screening and Assessment for Key Gaps in Care

Screening questions and burden assessments for case management of people with serious illness.

Proactive Patient Identification for Health Plans and ACOs: A Guide

Best practices in how to use data sources, such as claims or medical records, to identify patients who are most likely to benefit from palliative care.

Charlson Comorbidity Index

The Charlson Comorbidity Index can be used by palliative care programs to identify patients in need of their services.

Patient Identification and Assessment

Toolkit for finding the right patients at the right time to address gaps in care.

Comprehensive care requires an interdisciplinary approach. Use these tools to optimize processes and team health.

Serious Illness Strategies: Driving Value in High-Need Populations

A summary of implementation best practices for health plans and ACOs driving value in the care of high-need, seriously ill populations.

Role Clarity for a Highly Effective Interdisciplinary Team
MEMBERS ONLY locked

Clarify team roles and responsibilities to ensure positive relationships and productivity.

Best Practices in Telephonic Care Management
MEMBERS ONLY locked

Summary of care management strategies for members living with a serious illness, from preparing for the call to working with treating teams.

Best Practices in Initial Patient Outreach
MEMBERS ONLY locked

Advice from successful programs on how to make "cold calls" to patients identified to benefit from your services.

Team Health and Resilience
MEMBERS ONLY locked

Ensure strong morale and healthy team functioning.

Becoming Aware of Our Emotional Reactions to Improve Clinical Practice

This session covers how conscious and unconscious reactions impact communication with patients and families, and offers techniques to improve self-awareness and personal resilience.

Cultural Humility in Caring for People with Serious Illness

Defines cultural humility and how it influences patient care and offers ways to provide culturally humble care.

Easy-to-use, comprehensive training resources for all disciplines. Topics include effective serious illness communication, pain/symptom management, supporting caregivers, and more.

Training All Clinicians in Essential Communication and Symptom Management Skills

Tools to design and implement a training initiative for care teams from all specialties, to improve quality of life for patients and families living with serious illness.

CAPC Curriculum - Continuing Education Credits Overview

Course catalog for CAPC's clinical training curriculum. All courses provide continuing education credits for physicians, nurses, social workers, and care managers from all specialties and are free for CAPC members.

Communication Skills for Conversations About Serious Illness

This learning pathway, Communication Skills for Conversations About Serious Illness, contains training and tools to help health professionals navigate difficult conversations with patients living with a serious illness.

Empathetic Responses Guide
MEMBERS ONLY locked

This resource provides practical samples of empathic responses to use in conversations with patients and families, as well as template responses to challenging questions. Developed by VitalTalk.

Foundational Skills for Care Managers

This Learning Pathway contains a comprehensive set of training and tools to help care managers address the unique needs of patients and families living with serious illness.

Best Practices in Dementia Care and Caregiver Support

Strategies to alleviate suffering and improve quality of life for people living with dementia and their caregivers.

Addressing the physical, psychological, and social impacts of serious illness, as well as the functioning of a healthy interdisciplinary team. Includes 55 resources.
This toolkit provides online courses and resources for care managers to meet the needs of patients with serious illness. Includes 14 resources.
Toolkit for finding the right patients at the right time to address gaps in care. Includes 53 resources.

See all 47 Toolkits

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