System wide goals of care implementation: A podcast with Ira Byock, Chris Dale, and Matt Gonzales

System wide goals of care implementation: A podcast with Ira Byock, Chris Dale, and Matt Gonzales
GeriPal podcast; by Eric Widera, Alex Smith, Ira Byock, Chris Dale, Matt Gonzales; 7/24/25
Most health care providers understand the importance of goals-of-care conversations in aligning treatment plans with patients’ goals, especially for those with serious medical problems. And yet, these discussions often either don’t happen or at least don’t get documented. How can we do better? In today’s podcast, we sit down with Ira Byock, Chris Dale, and Matthew Gonzales to discuss a multi-year healthcare system-wide goals of care implementation project within the Providence Health Care System. Spanning 51 hospitals, this initiative [found] an increase from 7% to 85% in goals of care conversation documentation for patients who were in an ICU for 5 or more days. How did they achieve this? Our guests will share insights into the project’s inception and the strategies that drove its success, including:

• Organizational Alignment: Integrating GOC documentation into the health system’s mission, vision, and strategic objectives.
• Clinical Leadership Partnership: Collaborating with clinical leaders to establish robust quality standards and metrics.
• Ease of Documentation: Upgrading the electronic health record (EHR) system to streamline the documentation and retrieval of GOC conversations.
• Communication Training: Conducting workshops based on the Serious Illness Conversation Guide to equip clinicians with the skills needed for impactful GOC conversations.

[Hospice & Palliative Care Today covered this NEJM Catalyst source article 5/24/25: Successful strategies for operationalizing goals-of-care documentation.]