Goals-of-care conversations are a necessary tool in gathering information about patients healthcare wishes.
"These conversations are intended to elicit the values, preferences, and wishes of a patient so that all care is concordant with those patient wishes," says Kristen Lakis, Duke Palliative Care Strategic Services Associate.
Duke CARES
With the goal of increasing the quality and frequency of these important conversations, Duke Health started a new initiative in 2019 called Duke CARES (Conversations Anchored in Respect, Evidence, and Shared decision-making). This initiative partners with clinicians around the health system, builds on current practices, and trains the proper way to document and report when these communications happen.
Pilot Groups
Building this effort in to the workflow of a busy inpatient or outpatient setting can be tricky. The team has started this process with pilot groups at the Duke Outpatient Clinic and the Duke Center For Brain & Spine Metastasis. These pilot groups help identify populations to target for conversations, look at available resources, and develops a workflow that builds on the strengths of the unit in order to have these conversations consistently in a sustainable way.
"We focus the reporting tools to help them track the improvements in the quality and frequency of conversations," adds Lakis.
Video Library
"We have been creating a video library that teaches the core skills of having a goals of care conversation," says Lakis.