The Conversation Project is a public engagement initiative of the Institute for Healthcare Improvement with a goal both simple and transformative: to help everyone talk about their wishes for care through the end of life, so those wishes can be understood and respected. The Project believes these conversations should begin at the kitchen table—not in the intensive care unit—with the people who matter most, before it’s too late. Founded in 2010 when Pulitzer Prize-winning writer Ellen Goodman and colleagues gathered to share stories of “good deaths” and “hard deaths” within their own circles, The Conversation Project offers free tools, guidance, and resources, including the Conversation Starter Guide, now downloaded over 795,000 times by people in all 50 states and more than 160 countries. Since launching in 2012, more than 2.6 million people have turned to the website for support, clarity, and courage in opening conversations that matter.
Why it matters: 92% of Americans say it’s important to talk about end-of-life care wishes, yet only 32% have had that conversation—a gap between values and action that leaves families making impossible decisions in crisis moments without knowing what their loved ones would want. By providing accessible tools and framing these conversations as something that happens with the people who matter most rather than as medical or legal procedures, the Project removes barriers that keep people from discussing what they deeply want to discuss. The statistic that more than half would feel relief in having these conversations reveals that the hesitation isn’t about not wanting to talk—it’s about not knowing how to start, which is exactly what kitchen-table tools and guidance can solve.
