Shared goals of care Patient deterioration programme A

Shared goals of care (Patient deterioration programme) A brief introduction

What are shared goals of care and why are we doing this work? • Aim: all patients receive appropriate, necessary care that reflects their values, wishes and preferences • Currently variation across New Zealand • Some patients are receiving unwanted or unwarranted care

Shared goals of care discussion principles • Proactively align patient, family, whānau and clinician goals • May be one off or ongoing/updated • Undertaken with all adult inpatients • Led by the appropriate clinician (and includes others) • Should happen as early as possible in the admission • Should take place in an appropriate environment • Must be clearly documented • Need to be underpinned by Te Tiriti o Waitangi

Approach to shared goals of care

The discussion • Includes people important to the patient • Patients have asked that staff who spend the most time with them be able to start, add to, continue the discussion about shared goals • Led by appropriate clinician • Supported by selected members of multidisciplinary team

The decision • A shared decision if possible • Decision made by a senior clinician (usually registrar or senior medical officer) • Documented clearly, only one box ticked • Medical review if condition changes • New form needed if the decision changes

Support for shared goals of care discussions For resources: • www. hqsc. govt. nz/our-programmes/patientdeterioration/workstreams/shared-goals-of-care • www. hqsc. govt. nz/our-programmes/talkingcovid/publications-and-resources For advice: contact your DHB patient deterioration programme lead