Determining and documenting Goals of Care at every admission is important to ensure appropriate medical treatment is provided to our patients at any time.
To avoid unnecessary ICU referrals, code blues and MET calls, all patients must have Goals of Care documented clearly in GOC-SF in EMR on admission.
Any limitations of care (GOC-B, C or D) must be approved by the consultant as soon as practicable and reasons clearly documented and discussed with the patient and family.
For Patients whose Goals of Care are Supportive or Palliative (Goals of Care C) the option for MET Call is being removed.
For these patients:
- Deterioration must trigger a clinical review by the home team. After hours such review would be provided by the most senior doctor on duty who is encouraged to discuss with the consultant on call.
- Home team may consult the relevant medical or surgical team as well as ICU for advice.
- At later phases of the pandemic, if ICU capacity is overwhelmed, ICU may not be able to provide advice and support.
This change will be effective from 15 April 2020.
The relevant PROMPT documents are being updated and will be communicated to all clinical staff over the coming days.
Authorised by Dr Anjali Dhulia, Chief Medical Officer
Signed off by HICT 8 April 2020