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Title
Goals of care: a clinical framework for limitation of medical treatment.
Date Issued
2014-10-20
Author(s)
Thomas RL
Zubair MY
Hayes B
Ashby MA
Abstract
A novel clinical framework called "goals of care" (GOC) has been designed as a replacement for not-for-resuscitation orders. The aim is to improve decision making and documentation relating to limitations of medical treatment. Clinicians assign a patient's situation to one of three phases of care - curative or restorative, palliative, or terminal -according to an assessment of likely treatment outcomes. This applies to all admitted patients, and the default position is the curative or restorative phase. GOC helps identify patients who wish to decline treatments that might otherwise be given, such as treatment with blood products. This includes patients for whom specific limitations apply because of their beliefs. GOC has been introduced at Royal Hobart Hospital, Tasmania, and at Northern Health, Melbourne. So far, audit data and staff feedback have been favourable. There have been no reported major incidents or complaints in which GOC has been causally implicated in an adverse outcome.
Publication information
The Medical journal of Australia 2014-10-20; 201(8): 452-5
Type
Journal Article
Review
Journal Title
The Medical journal of Australia
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