Factors That Impact Family Perception of Goal-Concordant Care at the End of Life

Concordance of End-of-Life Care With End-of-Life Wishes in an Integrated Health Care System

“…One consequence of this lack of standard definitions and approaches is that the results of this study tend to align with those studies that have used similar methods and diverge from studies that took different approaches. For example, on an overall measure of concordance, 3 studies relied on next-of-kin reports for decedents 65 years and older and reported that the percentages of patients whose wishes met were 87.4%, 47 81.1%, 20 and 76% 48 -not so different from the 88.9% found in the current study. However, a study 49 of patients with advanced cancer found only 68% received care consistent with preferences.…”

Patient-Reported Receipt of Goal-Concordant Care Among Seriously Ill Outpatients—Prevalence and Associated Factors

“…3,8 Surveying bereaved caregivers' impressions of goal-concordant care is limited by potentially inadequate caregiver knowledge of patient goals and by recall bias. 3,[8][9][10] The comparison of advance directives with subsequent care documented in the electronic health record (EHR) is limited by the inherent vagueness of advance directives, poor documentation in the EHR, and potential changes in goals over time. [11][12][13] Moreover, retrospective assessment of the EHR for alignment between patients' goals and received treatments may be difficult because raters often disagree about the goals that treatments aim to achieve.…”

Analysis of the Time Interval between the Physician Order for Life-Sustaining Treatment Completion and Death

“…Arguably, when health professionals treat patients in ways that do not match patient values and wishes, grave medical errors may occur. 3,8) Previous studies identified that acute medical treatments administered against patient wishes may result in higher medi-cal costs and decreased quality of life. [9][10][11] In this sense, the study findings demonstrate an urgent need for clearer, more detailed guidance to assist healthcare professionals with deciding ideal timing for POLST form completion.…”

“…Therefore, it should be emphasized that the effectiveness of the law largely depends on ideal timing of POLST form completion. Arguably, when health professionals treat patients in ways that do not match patient values and wishes, grave medical errors may occur [ 3 , 8 ]. Previous studies identified that acute medical treatments administered against patient wishes may result in higher medical costs and decreased quality of life [ 9 - 11 ].…”