Goals Of Care Discussion Template

Goals of Care Discussions (GOCDs) are crucial conversations between healthcare professionals and patients/families about the patient’s wishes, expectations, and preferences for their medical treatment. These discussions help establish a clear understanding of what care is desired, acceptable, and not desired, ensuring that the patient receives the right care at the right time. In this article, we’ll outline a comprehensive GOCD template to guide these critical conversations.

1. Establish a Foundation: Patient/Family Understanding

The first step in a GOCD is to ensure that the patient/family understands the purpose and process of the discussion. This involves explaining that the goal is to identify their wishes for care and treatment, and to discuss their values and priorities. The discussion should be patient-centered, with an emphasis on supporting their autonomy and decision-making capacity.

2. Assess Patient’s Condition and Context

Before discussing goals of care, healthcare professionals should assess the patient’s current condition, including their diagnosis, treatment options, and prognosis. This context will help inform the discussion and ensure that the patient’s wishes are grounded in a realistic understanding of their situation.

3. Discuss Advance Care Planning (ACP)

AACP involves creating a document that outlines a patient’s wishes for their medical treatment in the event they become unable to make decisions for themselves. The healthcare provider should discuss ACP options with the patient/family, including the benefits and risks of each.

4. Explore Values and Priorities

This section of the GOCD involves engaging the patient in a conversation about their core values, such as quality of life, personal autonomy, and spiritual beliefs. By identifying these values, the patient can communicate their priorities for their care.

5. Identify Desired Health Outcomes

Based on the patient’s values and priorities, healthcare providers can explore their desired health outcomes, such as prolonging life, relieving pain, or improving quality of life. The discussion should involve weighing the benefits and risks of different treatment options.

6. Discuss Prognosis and End-of-Life Care

The healthcare team should discuss the patient’s prognosis, including their likelihood of recovery or decline. This section should also involve a conversation about end-of-life care, including pain management, comfort care, and other support services.

7. Consider Medical Interventions

In this section, the patient and healthcare team discuss specific medical interventions, such as CPR, mechanical ventilation, or tube feedings. The discussion should involve weighing the potential benefits and risks of each intervention.

8. Identify Support Systems and Resources

The patient’s support system, including their family, friends, and any spiritual or cultural advisors, plays a crucial role in care planning. The healthcare provider should discuss the importance of their involvement and connect them with relevant resources for support.

9. Update Advance Directives and Medical Orders

As the GOCD progresses, the patient should update their advance directive(s) and medical orders to reflect their wishes. The healthcare provider can help facilitate this process, ensuring that the patient’s choices are documented and easily accessible.

10. Ongoing Communication and Review

Goals of Care Discussions are not a one-time event but rather an ongoing process. Regular review and updates are essential to ensure that the patient’s wishes remain current and applicable to their changing condition.

The Goals of Care Discussion template provides a framework for critical conversations about patient care. By following these steps and using this template, healthcare providers can support patients and their loved ones in making informed decisions about their treatment and ensure that care is aligned with their values and priorities.