The Pitfalls of Utilizing "Goals of Care" as a Clinical Buzz Phrase: A Case Study and Proposed Solution.

Adrienne Klement, Sean Marks
Author Information
  1. Adrienne Klement: Section of Palliative Care, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
  2. Sean Marks: Section of Palliative Care, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.

Abstract

Assistance with discussing goals of care is one of the most common reasons clinicians seek out palliative care consultation. In practice though, the phrase "goals of care" is often utilized as a buzz phrase that lacks a shared understanding of its clinical relevance. We present a case example in which breakdowns in communication occurred between a patient and clinicians due to misunderstandings of the meaning of the phrase "goals of care." Subsequently, we review the literature to propose a unified definition of "goals of care" in hopes to minimize differences in what this phrase implies in clinical practice. We also seek to introduce a standardized process for establishing goals of care that may offer a more reliable and measurable method to promote goal-concordant care.

Keywords

References

  1. J Clin Oncol. 2017 Aug 1;35(22):2551-2557 [PMID: 28574777]
  2. J Palliat Med. 2011 Jan;14(1):17-23 [PMID: 21133809]
  3. Ann Surg. 2016 Jan;263(1):1-6 [PMID: 26649587]
  4. JAMA. 2017 Apr 11;317(14):1461-1470 [PMID: 28324029]
  5. Oncologist. 2016 Jan;21(1):110-8 [PMID: 26614711]
  6. J Clin Oncol. 2011 Jun 10;29(17):2319-26 [PMID: 21555700]
  7. Arch Intern Med. 1997 Apr 14;157(7):733-7 [PMID: 9125004]
  8. Proc (Bayl Univ Med Cent). 2001 Apr;14(2):134-7 [PMID: 16369602]
  9. J Card Fail. 2013 Mar;19(3):193-201 [PMID: 23482081]
  10. Milbank Q. 2011 Sep;89(3):343-80 [PMID: 21933272]
  11. N Engl J Med. 2019 Oct 24;381(17):1603-1606 [PMID: 31644843]
  12. J Palliat Med. 2001 Fall;4(3):315-24 [PMID: 11596542]
  13. J Adv Nurs. 2017 Jun;73(6):1302-1314 [PMID: 28000241]
  14. Gerontologist. 2009 Aug;49(4):495-507 [PMID: 19491358]
  15. Intensive Care Med. 2017 Dec;43(12):1847-1849 [PMID: 28656453]
  16. BMJ Open. 2015 Oct 06;5(10):e009032 [PMID: 26443662]
  17. Ann Intern Med. 1999 May 4;130(9):744-9 [PMID: 10357694]
  18. N Engl J Med. 2013 Dec 12;369(24):2347-51 [PMID: 24328469]
  19. J Palliat Med. 2016 Jan;19(1):8-15 [PMID: 26417923]
  20. J Palliat Med. 2019 Sep;22(9):1026-1031 [PMID: 31329016]
  21. J Oncol Pract. 2017 Oct;13(10):e844-e850 [PMID: 28445100]

Word Cloud

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