ACP releases High Value Care advice for communicating about end-of-life care goals

Physician-patient communication about goals of care is a low-risk, high-value intervention for patients with a life-threatening illness, ACP recently advised in a paper published in JAMA Internal Medicine.

Co-authored for ACP's High Value Care Task Force by Rachelle E. Bernacki, MD, ACP Member, and Susan D. Block, MD, from the Center for Palliative Care at Harvard Medical School, “Communication about Serious Illness Care Goals: A Review and Synthesis of Best Practices” notes that a consistent and large body of mostly observational research shows that patient, physician, and system factors all contribute to deficiencies in serious illness care communication.

The paper reviews current literature and describes best practices in conversations about serious illness care goals. The paper offers practical advice for clinicians and health care systems about developing a systematic approach to the quality and timing of such communication to assure that each patient has a personalized serious illness care plan.

Effective communication about end-of-life care may also reduce costs. Best practices in discussing goals of care include sharing prognostic information, eliciting decision-making preferences, understanding fears and goals, exploring views on tradeoffs and impaired function, and determining wishes for family involvement, the authors write.

ACP's High Value Care initiative is designed to help doctors and patients understand the benefits, harms, and costs of tests and treatment options for common clinical issues so they can pursue care together that improves health, avoids harms, and eliminates wasteful practices.