+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

The Goals of Patient Care project: implementing a proactive approach to patient-centred decision-making

The Goals of Patient Care project: implementing a proactive approach to patient-centred decision-making

Internal Medicine Journal 44(10): 961-966

Patients in the later stages of their lives risk being harmed by futile or unwanted interventions if realistic care goals and patient values are not recognised. Doctors have difficulty discussing and informing patients' healthcare goals. To review implementation of a Goals of Patient Care (GOPC) summary in medical inpatients and its applicability in emergency medical response (EMR) situations. Single-centre cross-sectional study of adult medical inpatients and adult inpatients requiring EMR at a Victorian general hospital. presence and content of GOPC summary, secondary review of decision-making and discussion documentation, patient characteristics; EMR precipitants and outcomes. GOPC were documented for 82 of 101 patients. One had an existing advance directive, and six had records of a patient-appointed substitute decision-maker. For patients with GOPC, 80 had life-prolonging treatment aims, with a varying degree of treatment limitation in 48. Discussion with patient or substitute decision-maker was evident in 43 cases. GOPC were documented prior to nine of 23 EMR. The EMR triggered a GOPC modification in three instances. Introduction of a routine GOPC summary encourages consideration of goals of care for most medical inpatients. Few have pre-existing records of their wishes, and there are opportunities for improvement in this regard. Doctors may still have difficulty determining goals of care, and discussion of GOPC with patients and families may not be clearly documented. Most patients requiring EMR do not have prior GOPC review, and the role of the summary in these situations remains unclear.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 056187381

Download citation: RISBibTeXText

PMID: 24942613

DOI: 10.1111/imj.12511

Related references

Examining chronic care patient preferences for involvement in health-care decision making: the case of Parkinson's disease patients in a patient-centred clinic. Health Expectations 20(4): 655-664, 2017

Professional centred shared decision making: patient decision aids in practice in primary care. Bmc Health Services Research 8: 5, 2008

Support for teams, technology and patient involvement in decision-making associated with support for patient-centred care. International Journal for Quality in Health Care 2018:, 2018

A patient-centred approach to biological treatment decision making for psoriasis: an expert consensus. Journal of the European Academy of Dermatology and Venereology 29(12): 2390-2398, 2015

Implementing shared decision making in diverse health care systems: the role of patient decision aids. Patient Education and Counseling 57(3): 247-249, 2005

When patient-centred care is worth doing well: informed consent or shared decision-making. Bmj Quality and Safety 26(7): 522-524, 2017

Putting the Patient in Patient-Centred Care: Pilot Testing an Updated Patient Decision Aid for Plaque Psoriasis. Journal of Cutaneous Medicine and Surgery 23(1): 119-120, 2019

Developing, implementing, and evaluating decision support systems for shared decision making in patient care: A conceptual model and case illustration. Journal of Biomedical Informatics 35(5-6): 313-321, October-December, 2002

Resident centred decision-making and end-of-life treatment in long-term care: what are the consequences to the elderly patient?. Perspectives ) 33(2): 10-17, 2009

Palliative care and the arts: vehicles to introduce medical students to patient-centred decision-making and the art of caring. Bmc Medical Education 17(1): 257, 2017

Shared Decision Making in Prostate Cancer Care-Encouraging Every Patient to be Actively Involved in Decision Making or Ensuring the Patient Preferred Level of Involvement?. Journal of Urology 200(3): 582-589, 2018

The long way of implementing patient-centered care and shared decision making in Germany. Zeitschrift für Evidenz Fortbildung und Qualitat Im Gesundheitswesen 123-124: 46-51, 2017

Automated integration of wireless biosignal collection devices for patient-centred decision-making in point-of-care systems. Healthcare Technology Letters 3(1): 34-40, 2016

Patient-centred care and shared decision making in Chile: Rising momentum for progress and implementation in clinical practice. Zeitschrift für Evidenz Fortbildung und Qualitat Im Gesundheitswesen 123-124: 28-31, 2017

Wound care nursing - a patient-centred approach: second edition Sue Bale Wound care nursing - a patient-centred approach: second edition and Vanessa Jones Elsevier 235pp £24.99 0 7234 3344 5 0723433445 [Formula: see text. Nursing Standard 1987) 20(43): 37-37, 2006