ADCC's Improving Goal Concordant Care Initiative: Implementing Primary Palliative Care Principles

Area of Science:

• Oncology
• Palliative Care
• Healthcare Quality Improvement

Background:

• High-quality goals of care communication (GOCC) is crucial for patient-centered cancer care.
• Oncologists often face challenges in delivering and documenting GOCC due to lack of training and support.

Purpose of the Study:

• To describe the design and early implementation of the Improving Goal Concordant Care (IGCC) Initiative.
• To assess the feasibility and initial outcomes of a multi-site initiative to enhance GOCC in academic cancer centers.

Main Methods:

• The IGCC initiative involved four core components: communication skills training (CST), structured electronic health record documentation, defined GOCC expectations, and a measurement framework.
• The RE-AIM framework guided the evaluation of process and outcome measures, including CST completion, clinician-reported outcomes, patient-reported measures (Heard and Understood scale), and future claims-based utilization metrics.

Main Results:

• Implementation of IGCC components is underway at all 10 participating centers.
• 35% of clinicians completed CST, with high ratings for quality and likelihood to recommend. Patient-reported data collection is ongoing, with slow but progressing uptake of GOCC documentation.

Conclusions:

• The IGCC initiative demonstrates a structured approach to improving GOCC in academic cancer centers.
• Flexibility in implementation is key for collaboration but complicates the assessment of intervention effectiveness and fidelity.