Designing Performance Feedback about Goals of Care Conversations in VA CLCs and HBPC sites

Landis-Lewis Z. Designing Performance Feedback about Goals of Care Conversations in VA CLCs and HBPC sites. VIReC Using Data & Information Systems in Partnered Research [Cyberseminar]. VA Information Resource Center. 2018 Jun 19.

The Veterans Hospital Administration Handbook 1004.03, "Life Sustaining Treatment Decisions: Eliciting, Documenting, and Honoring Patients' Values, Goals, and Preferences" was released in January 2017 to standardize conduct and documentation of Goals of Care Conversations (GOCCs) regarding seriously ill Veterans' goals and preferences for life sustaining treatment (LST). As part of a VA QUERI program to support implementation, we designed performance feedback reports to staff conducting those conversations. We developed a reporting tool that could support national-scale reporting for the initiative. Our project resulted in a) the definition of appropriate measures of GOCC documentation, b) identification of data sources that support accurate measurement, c) the design of appropriate graphical displays of feedback, and d) the development of an open source software tool that supports local customization of performance reports. Eleven individuals from 4 sites participated in 12 design iterations of graphical displays of performance. We developed definitions of GOCC completion for 1) timeliness following admission, and 2) completeness for admitted Veterans. Participants' preferences for feedback varied for a) definitions for measures, b) prioritization of measures, c) graphical displays of GOCC conduct, and d) intention to disseminate feedback data to frontline professionals.