Asking “What Matters Most” in Heart Failure Care: It’s Never Too Soon

The unpredictable trajectory of heart failure often leads clinicians to postpone conversations about what matters most to patients until they feel certain a patient is nearing the end of life. Many worry about initiating these discussions “too early,” waiting for the “right time,” or fear causing distress to patients and families. However, delaying these conversations can limit understanding, hinder preparation, and contribute to avoidable stress during the dying process. Misconceptions among patients and families can further complicate communication. Many conflate palliative care with hospice, leading to values-focused conversations occurring only during moments of crisis when time is limited and emotions are high. By normalizing early conversations about what matters most, clinicians can ensure treatment decisions remain closely aligned with patient priorities across the disease trajectory.

Simple micro-prompts such as “What are you hoping for?”, “What is most important to you right now?”, and “What are you most worried about?” offer a practical way to elicit patient values, support shared decision-making, and connect recommended self-care behaviors to what patients deeply care about. Early discussions also help families prepare for future transitions, potentially reducing unwanted hospitalizations and supporting preferred care settings.

This mini-workshop will provide practical, actionable strategies for members of the interdisciplinary heart failure team. The first mini-lecture introduces micro-prompts to initiate values-based conversations earlier in the disease course. The second offers communication techniques for complex or emotionally charged end-of-life discussions. The session concludes with a facilitated skills-practice exercise, allowing attendees to apply and refine techniques in real time.

With increasing emphasis on patient-centered outcomes in heart failure care, early values-based communication has never been more essential. Content is designed for physicians, advanced practice providers, nurses, social workers, and all members of the heart failure care team. Participants will leave with practical scripts and communication tools they can implement immediately in clinical practice.

Learning Objectives

• Describe the role of values-based communication in heart failure care and its impact on patient and family outcomes.
• Demonstrate the use of micro-prompts to initiate conversations about what matters most to patients with heart failure across the illness trajectory.
• Apply communication techniques to navigate challenging end-of-life discussions while aligning care with patient values.