End of Life (The Electronic Version)

Documentation of conversations with dying patients about goals of care and end-of-life treatment decisions often aren't accessible when needed — the details wind up buried in a long-ago progress note and can be impossible to unearth when needed. As part of a quality-improvement project, clinicians at Memorial Sloan Kettering Cancer Center in New York introduced a specific “end of life” templated note into their health record software. The template includes a checklist of boxes to confirm that clinicians have discussed specific topics (e.g., “expected course of illness,” “treatment intent,” “patient goals”). Decisions about resuscitation and hospice are confirmed with additional boxes. A blank space for narrative comments is appended.

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