The following is a summary of “Just-in-Time Decision Making: Preliminary Findings of a Goals of Care Rapid Response Team,” published in the APRIL 2023 issue of Pain Management by Zhukovsky, et al.

In response to the COVID-19 pandemic, a Comprehensive cancer center established a Goals of Care Rapid Response Team (GOC RRT) to optimize resource utilization while ensuring goal-concordant patient care. For a study, researchers sought to evaluate the feasibility of GOC RRT by describing the frequency of consultations from those requested, adherence to consultation processes regarding core team member participation, and preliminary efficacy in limiting care escalation.

A retrospective chart review was conducted for patients referred to GOC RRT between March 23, 2020, and September 30, 2020. Descriptive analysis was performed, and categorical variables were compared with Fisher’s exact or Chi-Square tests and continuous variables with Mann-Whitney U tests.

89 patients in all were recommended. 95 consultations were conducted on 85% (76 of 89). The average patient was 61 (49–69) years old, 54% (48–89) male, 17% (17–89) Hispanic, 48% (43–89) White, 73% (65–89) married or in a relationship, and 66% (59–89) Christian. There was a similar distribution of solid tumors and hematologic malignancies (53% [47/89] vs. 47% [42 of 89, P = 0.199]). Most patients (82%, 73 of 89) had leukemia that had relapsed or had spread to other organs. COVID-19 was confirmed in 7% of cases (6 of 89). Of 89 patients, 61 died during the index hospitalization, or 69%. There was no statistically significant difference in the demographic or clinical characteristics between groups (no consultation, one consultation, or more consultations). For 61 out of 95 consultations, core team members were present 64% of the time. Of the 76 patients, 56 (74%) had care limitations.

GOC RRT consultations were feasible and associated with care limitations. Adherence to core team participation was fair, and the study demonstrated the preliminary efficacy of the GOC RRT in limiting care escalation while ensuring goal-concordant patient care.

Source: jpsmjournal.com/article/S0885-3924(22)01003-X/fulltext