Identifying Patients in Need of Goals of Care Conversations: Reliability, Acceptability, and Prognostic Significance of the Preference-Aligned Communication and Treatment Conversation Trigger Tool for Patients with Cancer

Lauren Chiec*, Eytan Szmuilowicz, Jayson Neagle, Katie Clepp, Gordon J. Wood

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background: Simple methods to help teams identify patients with goals of care (GOC) conversation needs are lacking. Objectives: To develop a tool to identify hospitalized patients who may benefit from GOC conversations. Methods: The Preference-Aligned Communication and Treatment (PACT) Conversation Trigger Tool was implemented as part of a quality improvement initiative in 10 Illinois hospitals and validated in a cohort of patients admitted to the coordinating site's oncology unit (n = 135). Results: The tool was reliable and acceptable to clinicians using it across sites. Thirty percent (n = 40) of patients screened at the coordinating site's oncology unit triggered positive. These patients were more likely to have a do-not-resuscitate order (43% vs. 11%) and palliative care consult (53% vs. 20%) and had lower mean survival time (125 vs. 248 days) than those who did not trigger (p < 0.001). Conclusions: The tool is reliable, acceptable, and can identify hospitalized oncology patients who may benefit from GOC conversations.

Original languageEnglish (US)
Pages (from-to)1249-1253
Number of pages5
JournalJournal of palliative medicine
Volume25
Issue number8
DOIs
StatePublished - Aug 1 2022

Funding

This study was supported by Blue Cross Blue Shield of Illinois. The funding source was not involved in the study design, in collection, analysis, or interpretation of data, in the writing of the report, or in the decision to submit the article for publication.

Keywords

  • goals of care
  • hospital oncology service
  • palliative care
  • prognosis

ASJC Scopus subject areas

  • General Nursing
  • Anesthesiology and Pain Medicine

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