Goals of care - Revision history

Danbot: Add verified PubMed references (PMIDs 32773044, 35725231)

2026-03-22T10:50:01Z

Add verified PubMed references (PMIDs 32773044, 35725231)

← Older revision		Revision as of 10:50, 22 March 2026
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	==Background==		==Background==
	*Patients with documented advanced care plans have fewer hospitalizations in their last months of life and are more likely to receive care in accordance with their wishes.		*Patients with documented advanced care plans have fewer hospitalizations in their last months of life and are more likely to receive care in accordance with their wishes. <ref>Comer A, Fettig L, Torke AM. Identifying Goals of Care. Med Clin North Am. 2020 Sep;104(5):767-775. PMID 32773044</ref>
	*In sign out from previous team, ask about Code Status if the patient is sick.		*In sign out from previous team, ask about Code Status if the patient is sick.
	*Varies by state to state. State-by-state information can be found at: http://www.polst.org/programs-in-your-state/.		*Varies by state to state. State-by-state information can be found at: http://www.polst.org/programs-in-your-state/.
	*For critically ill patients, open frank discussion around resuscitation and end of life preferences is required (often before rapport can be established).		*For critically ill patients, open frank discussion around resuscitation and end of life preferences is required (often before rapport can be established). <ref>Choi A, Sanft T. Establishing Goals of Care. Med Clin North Am. 2022 Jul;106(4):653-662. PMID 35725231</ref>

	==Scenarios==		==Scenarios==

2022-04-11T17:01:51Z

Difficult Situations

← Older revision		Revision as of 17:01, 11 April 2022
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	==Difficult Situations==		==Difficult Situations==
	*Discordant Guidance		*Discordant Guidance
	**Family members sometimes disagree with the POLST or in moments of heightened emotions, are not yet ready to ~~loose~~ their loved one. Guilt from an estranged family member who recently arrives may also play into the complicated psycho-social factors that contribute to this discordant guidelines.		**Family members sometimes disagree with the POLST or in moments of heightened emotions, are not yet ready to lose their loved one. Guilt from an estranged family member who recently arrives may also play into the complicated psycho-social factors that contribute to this discordant guidelines.

	*In California, the treating physician and surrogate (family) have the power to override the POLST in the event of incapacity.		*In California, the treating physician and surrogate (family) have the power to override the POLST in the event of incapacity.

2020-07-24T10:58:41Z

External Links

← Older revision		Revision as of 10:58, 24 July 2020
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	==External Links==		==External Links==
			*Step by Step Rapid Code Status Conversation Guide https://www.aliem.com/rapid-code-status-conversation-guide/
	*http://www.canhr.org/reports/2010/POLST_WhitePaper.pdf		*http://www.canhr.org/reports/2010/POLST_WhitePaper.pdf
	*https://depts.washington.edu/bioethx/topics/dnr.html		*https://depts.washington.edu/bioethx/topics/dnr.html

2019-10-07T13:28:43Z

References

← Older revision		Revision as of 13:28, 7 October 2019
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	[[Category:Misc/General]]		[[Category:Misc/General]]
	[[Category:Palliative Medicine]]		[[Category:Palliative Medicine]]
			[[Category:Critical Care]]

2017-07-09T09:24:57Z

2017-05-31T05:01:32Z

← Older revision		Revision as of 05:01, 31 May 2017
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	*[[Delivering bad news]]		*[[Delivering bad news]]

	==~~References~~==		==External Links==
	*"Code Status Discussion" UCSF Hospitalist Handbook. Chapter Palliiative Care. Resident editors: Rachel J. Stern, MD Margaret C. Lynch, MD Faculty Editors: Kara Bischoff, MD Wendy Anderson, MD.
	~~California Probate Code 4780(c)~~
	*http://www.canhr.org/reports/2010/POLST_WhitePaper.pdf		*http://www.canhr.org/reports/2010/POLST_WhitePaper.pdf
	*https://depts.washington.edu/bioethx/topics/dnr.html		*https://depts.washington.edu/bioethx/topics/dnr.html

			==References==
			<references/>

	[[Category:Misc/General]]		[[Category:Misc/General]]
	[[Category:Palliative Medicine]]		[[Category:Palliative Medicine]]

2016-08-01T09:04:25Z

Text replacement - "doesn't" to "does not"

← Older revision		Revision as of 09:04, 1 August 2016
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	*Slow Codes		*Slow Codes
	**When a provider ~~doesn't~~ think that proceeding with coding a patient is consistent with the patients' wishes, there is a tendency to run a "slow code" (AKA "show code") which was symbolic resuscitations. The idea behind is to perform a resuscitation to benefit the family whole minimizing harm to the patient. These types of codes can undermine the trust that patients/families have in health care providers. As such, they can be problematic. (https://depts.washington.edu/bioethx/topics/dnr.html)		**When a provider does not think that proceeding with coding a patient is consistent with the patients' wishes, there is a tendency to run a "slow code" (AKA "show code") which was symbolic resuscitations. The idea behind is to perform a resuscitation to benefit the family whole minimizing harm to the patient. These types of codes can undermine the trust that patients/families have in health care providers. As such, they can be problematic. (https://depts.washington.edu/bioethx/topics/dnr.html)

	==Key Points==		==Key Points==

2016-07-13T03:56:27Z

2016-07-12T07:42:54Z

References

← Older revision		Revision as of 07:42, 12 July 2016
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	*A healthcare representative (conservator, guardian, or closest relative) can revoke, change, or execute a new POLST form on behalf of the patient if they are incapacitated, meaning they would get final say (in California, may vary by state)		*A healthcare representative (conservator, guardian, or closest relative) can revoke, change, or execute a new POLST form on behalf of the patient if they are incapacitated, meaning they would get final say (in California, may vary by state)
	*When in doubt, err on the side of resuscitating.		*When in doubt, err on the side of resuscitating.

			==See Also==
			*[[Delivering bad news]

	==References==		==References==
	"Code Status Discussion" UCSF Hospitalist Handbook. Chapter Palliiative Care. Resident editors: Rachel J. Stern, MD Margaret C. Lynch, MD Faculty Editors: Kara Bischoff, MD Wendy Anderson, MD.		*"Code Status Discussion" UCSF Hospitalist Handbook. Chapter Palliiative Care. Resident editors: Rachel J. Stern, MD Margaret C. Lynch, MD Faculty Editors: Kara Bischoff, MD Wendy Anderson, MD.
	California Probate Code 4780(c)		California Probate Code 4780(c)
	(http://www.canhr.org/reports/2010/POLST_WhitePaper.pdf)		*http://www.canhr.org/reports/2010/POLST_WhitePaper.pdf
	(https://depts.washington.edu/bioethx/topics/dnr.html)		*https://depts.washington.edu/bioethx/topics/dnr.html

	[[Category:Misc/General]]		[[Category:Misc/General]]
	[[Category:Palliative Medicine]]		[[Category:Palliative Medicine]]

2016-06-30T20:58:59Z

Rossdonaldson1 moved page Code Discussion to Goals of care

← Older revision	Revision as of 20:58, 30 June 2016
(No difference)