Do goals of care documentation reflect the conversation?: Evaluating conversation-documentation accuracy.

ABSTRACT:

Background

Documenting goals of care in the electronic health record is meant to relay patient preferences to other clinicians. Evaluating the content and documentation of nurse and social worker led goals of care conversations can inform future goals of care initiative efforts.

Methods

As part of the ADvancing symptom Alleviation with Palliative Treatment trial, this study analyzed goals of care conversations led by nurses and social workers and documented in the electronic health record. Informed by a goals of care communication guide, we identified five goals of care components: illness understanding, goals and values, end of life planning, surrogate, and advance directives. Forty conversation transcripts underwent content analysis. Through an iterative team process, we d

SUBMITTER: Ma JE 

PROVIDER: S-EPMC11323159 | biostudies-literature | 2024 Aug

REPOSITORIES: biostudies-literature