Intervention Physicians and advance practice clinicians who were treating the patients randomized to the intervention received a 1-page, patient-specific intervention (Jumpstart Guide) to prompt and guide goals-of-care discussions. Randomization occurred between April 2020 and March 2021 and was stratified by study site and history of dementia. Patients with documented goals-of-care discussions or a palliative care consultation between hospital admission and eligibility screening were excluded. Eligible hospitalized patients were aged 55 years or older with any of the chronic illnesses used by the Dartmouth Atlas project to study end-of-life care or were aged 80 years or older. Objective To evaluate a communication-priming intervention to promote goals-of-care discussions between clinicians and hospitalized older patients with serious illness.ĭesign, Setting, and Participants A pragmatic, randomized clinical trial of a clinician-facing communication-priming intervention vs usual care was conducted at 3 US hospitals within 1 health care system, including a university, county, and community hospital. Importance Discussions about goals of care are important for high-quality palliative care yet are often lacking for hospitalized older patients with serious illness.
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