Patients and Clinicians Discuss Only 2 of 11 Goals of Care Elements

Studies showing lackluster rates of advance care planning are nothing new.  But this new study in the Canadian Medical Association Journal is particularly disturbing.  

The authors identified 11 recommended elements of goals-of-care discussions that are the most important to older adults patients in hospital with serious illness and their family members.  They found that these elements are VERY infrequently addressed by health care providers in hospital.

1. Asked the respondent about preferences for care in event of life-threatening illness


2. Inquired about the respondent’s values


3. Discussed prognosis 


4. Gave an opportunity for the respondent to express fears or concerns


5. Asked the respondent if they had additional questions about goals of care


6. Provided information about outcomes, risks, benefits of comfort care


7. Asked about prior discussions or written documents


8. Offered a time to meet to discuss goals of care


9. Provided information about outcomes, risks, benefits of life sustaining treatments


10. Provided information to review about advance care planning before discussions


11. Helped access legal documents to record advance care plans