Impact of Covid-19 Pandemic on Goals of Care Conversations at Veterans Affairs Hospitals

摘要: Rationale Goals of care conversations (GoCCs) are vital to equitable, patient-centered end-of-life decision-making. The Covid-19 pandemic strained providers conducting GoCCs due to changing clinical workloads and contexts, concerns about resource scarcity, and the uncertain prognosis associated with a new virus. It is unknown how these changes affected shared decision-making (SDM) and willingness to provide life-sustaining treatment (LST) recommendations during GoCCs. We sought to assess provider’s views and reported behaviors related to GoCCs during the Covid-19 pandemic versus pre-pandemic. Methods We developed a survey gauging respondents’ attitudes and behaviors regarding GoCCs. For several survey items, providers were asked to answer first thinking about the pre-Covid-19 period and again considering the height of the pandemic. We identified 20 VA facilities with high Covid-19 …