Unwanted or unwarranted treatments at the end of life can contribute to suffering for patients, families and whānau, moral distress for clinicians, and unnecessary expenditure for the health system.
Documented goals of care should represent the outcome of a shared decision-making process between the patient and the clinical team. At a minimum, the overall direction for an episode of care (eg, curative, restorative, palliative or terminal) and any agreed limitations on medical treatment need to be identified.
Effective communication is necessary to elicit patients’ values and preferences for care and ensure informed choices can be made about complex medical treatment options. Ideally these conversations occur prior to episodes of acute deterioration without the pressures of an evolving and emergent clinical crisis. Read the case for change (302kb, PDF).
On 26 October 2017, we hosted a workshop to understand current issues for shared goals of care for New Zealand. We filmed the presentations from the morning of this workshop, these and the summary report are available at the bottom of this page.
On 26 February 2018, we held a workshop with consumers to explore their perspectives, experiences and views on conversations about the risk of dying in hospital. A further workshop with the Alzheimers New Zealand consumer group was held in March 2018.
We have established a multi-disciplinary working group to develop a national approach to determining, communicating and documenting shared goals of care.
We will be looking for district health board hospitals to test this approach with us in 2019.
We are looking into opportunities to connect with people working on shared goals of care over the next year. Please get in contact with us if you are planning to implement or have oversight of your hospital’s shared goals of care approach.