Improving Discussions About Goals of Care for Patients with Severe Chronic Illnesses

High-quality discussions about goals of care between clinicians and chronically ill patients often are wanting in both quality and frequency. In this study, researchers explored a new approach to priming both physicians and patients for such discussions. They assembled a group of 124 primary care and outpatient subspecialty physicians and nurse practitioners who were caring for 537 patients with severe end-organ disease (e.g., metastatic or inoperable cancer, obstructive or restrictive lung disease, heart failure) and randomized the clinicians and patients to intervention or usual care. The intervention consisted of individual patient surveys to identify goals-of-care objectives and preferences, which were converted into one-page, patient-s…