LAUSR

Abstract Background: Discussing goals of care and advance care planning is beneficial, yet how to best integrate goals of care communication into clinical care remains unclear. Objective: To develop and determine the feasibility of a structured goals of care communication guide for nurses and social workers. Design/Setting/Subjects: Developmental study with providers in an academic and Veterans Affairs (VA) health system (n = 42) and subsequent pilot testing with patients with chronic obstructive pulmonary disease or heart failure (n = 15) and informal caregivers (n = 4) in a VA health system. During pilot testing, the communication guide was administered, followed by semistructured, open-ended questions about the content and process of communication. Changes to the guide were made iteratively, and subsequent piloting occurred until no additional changes emerged. Measurements: Provider and patient feedback to the communication guide. Results: Iterative input resulted in the goals of care communication gui...