Innovating with empathy: Dorothy Ley Hospice studies motivational interviewing in palliative care

• Impact
• Innovation

Published: June 26, 2025

Dorothy Ley Hospice is conducting its first formal research study, evaluating the use of motivational interviewing in hospice palliative care. The project is led by Dr. Chris Gilchrist, a Dorothy Ley Hospice Community Palliative Physician Team member and the hospice’s new director of research and quality improvement.

The role, introduced last year, reflects the hospice’s growing focus on innovation to improve care. “My goal is to really start acknowledging the work we are already doing here,” explains Dr. Gilchrist. “I want to formalize it more and then start sharing it with the broader community.”

Helping patients explore what matters most

Motivational interviewing is a patient-centred communication technique that helps people clarify their values and make decisions aligned with them. It’s a technique Dr. Gilchrist has used in his practice throughout his career, and one he believes holds significant promise for the field of palliative care in general.

“It’s about helping patients come to their own decisions about complex choices,” he explains. “This is what we do in almost every conversation with our patients in palliative care. They’re making tough choices where there may not be a medically right answer.”

For example, a patient might be faced with a choice about whether to continue doing testing—there may not be a medical reason to continue testing, but that’s not the only consideration.

Instead of saying, “Maybe we don’t want to test anymore,” using motivational interviewing, he might ask: “What do you understand about your illness?” followed by, “What do you see as the role of continued testing?”

“That’s when I start understanding them,” he says. “One person might reflect and say, ‘Maybe there isn’t much of a role anymore,’ while another might say, ‘It’s really important to me—I get anxious when I don’t know what’s happening inside,’”

So, using motivational interviewing, care team members can help patients arrive at the best choices for them—it’s about listening and asking questions rather than directing. But the technique doesn’t just benefit patients—there’s evidence it can also ease emotional strain on clinicians.

“Clinicians are exhausted. COVID just magnified that. And in palliative care, the emotional weight is already high,” says Dr. Gilchrist. “If there’s a tool like motivational interviewing that can help clinicians feel more effective in conversations, that’s a win.”

Studying the effect of better conversations

To evaluate the approach, the hospice team first surveyed patients and their loved ones to understand how supported they felt in decision-making. That provided a baseline.

Then, in December 2024, care providers received motivational interviewing training led by Dr. Gilchrist. It included workshops, educational resources, and ongoing discussion during team rounds.

Over the next three months, staff were encouraged to apply the technique, particularly in emotionally complex conversations. Now, the team is surveying patients again to assess any changes in the experience or perception of care.

System-wide potential

While the study could provide immediate benefits for the hospice’s care team and clients, the impact could extend far beyond. Palliative care is a relatively new and under-studied field. Dr. Gilchrist hopes the research at Dorothy Ley Hospice can help expand the available evidence base.

“If someone finds a great way to do something, we should study that in the right way to prove that it’s doing what we think, prove that it is having these benefits, and then we should share that with everyone,” says Dr. Gilchrist. “That’s how you advance medicine.”

But research like this can be costly, especially on a larger scale. That’s why the team is starting small, focusing on a study based entirely within Dorothy Ley Hospice.

“Having a stronger focus on research and quality improvement at a major community hospice is new—and it helps support our care,” he says, “The more we can dedicate resources to this, the more we’ll be able to grow and become a bigger player.”

The formalization of research underway at Dorothy Ley Hospice reflects a bold step toward inspiring innovation in hospice palliative care. By documenting and sharing what works, the team is improving its services and contributing to a broader shift in how the sector evolves. It’s a reminder that meaningful change often begins in small, focused ways—and grows through collaboration, evidence and the courage to lead.

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