"In the Beginning... ": Tools for Talking About Resuscitation and Goals of Care Early in the Admission

Jocelyn White, Erik K. Fromme

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Quality standards no longer allow physicians to delay discussing goals of care and resuscitation. We propose 2 novel strategies for discussing goals and resuscitation on admission. The first, SPAM (determine Surrogate decision maker, determine resuscitation Preferences, Assume full care, and advise them to expect More discussion especially with clinical changes), helps clinicians discover patient preferences and decision maker during routine admissions. The second, UFO-UFO (Understand what they know, Fill in knowledge gaps, ask about desired Outcomes, Understand their reasoning, discuss the spectrum Feasible Outcomes), helps patients with poor or uncertain prognosis or family-team conflict. Using a challenging case example, this article illustrates how SPAM and UFO-UFO can help clinicians have patient-centered resuscitation and goals of care discussions at the beginning of care.

Original languageEnglish (US)
Pages (from-to)676-682
Number of pages7
JournalAmerican Journal of Hospice and Palliative Medicine
Volume30
Issue number7
DOIs
StatePublished - Nov 2013
Externally publishedYes

Keywords

  • advance care planning
  • communication
  • goals of care
  • palliative care
  • resuscitation

ASJC Scopus subject areas

  • Medicine(all)

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