Establishing Goals of Care and End-of-Life Care in the Intensive Care Unit. A Period Prevalence Study

Identifying patient's goals and values at end of life is essential to providing patient-centred care. The purpose of this prospective cohort study was to describe the changes in goals of care and the nature of end-of-life care during admission to two intensive care units in South Australia. Under a quarter of patients had their goals of care documented on admission to the intensive care unit and among those who subsequently survived to hospital discharge, only 32% had their goals of care documented on hospital discharge. Most deaths in the intensive care unit occurred after withdrawal of life-sustaining interventions. Data from 154 family meetings were collected and consensus was achieved among all parties in most meetings. In this study, fewer than one in four patients had goals of care documented on admission to intensive care with marginal increases by ICU discharge. This represent an area of care that could be improved.