Identifying Patients in Need of Goals of Care Conversations: Reliability, Acceptability, and Prognostic Significance of the Preference-Aligned Communication and Treatment Conversation Trigger Tool for Patients with Cancer.

Simple methods to help teams identify patients with goals of care (GOC) conversation needs are lacking. To develop a tool to identify hospitalized patients who may benefit from GOC conversations. The Preference-Aligned Communication and Treatment (PACT) Conversation Trigger Tool was implemented as part of a quality improvement initiative in 10 Illinois hospitals and validated in a cohort of patients admitted to the coordinating site's oncology unit ( = 135). The tool was reliable and acceptable to clinicians using it across sites. Thirty percent ( = 40) of patients screened at the coordinating site's oncology unit triggered positive. These patients were more likely to have a do-not-resuscitate order (43% vs. 11%) and palliative care consult (53% vs. 20%) and had lower mean survival time (125 vs. 248 days) than those who did not trigger ( < 0.001). The tool is reliable, acceptable, and can identify hospitalized oncology patients who may benefit from GOC conversations.