• Telena Kerkham and Matthew Brain.
• Department of General and Acute Care Medicine, Launceston General Hospital, Launceston, Tasmania, Australia.
• Intern Med J. 2020 Nov 1; 50 (11): 1373-1376.

BackgroundIt is widely accepted that early discussions about goals of care (GOC) should occur during a hospital admission. Whilst rapid response systems such as Medical Emergency Team (MET) calls were designed to identify patients at risk of deterioration early enough in their illness to intervene, it is becoming apparent that these teams frequently diagnose the dying patient.AimsTo determine how frequently Launceston General Hospital MET doctors are involved in discussions surrounding GOC.MethodsA retrospective audit of all MET calls and Code Blues at the Launceston General Hospital over an 18 month period was performed.Results50% of MET calls occurred in patients with no valid GOC form completed prior. At 3% of events, the GOC form was completed for the first time, and at 3% it was modified. At a further 3% the notes implied there had been a modification to the GOC but the form had not been completed.ConclusionsThis audit confirms that documentation surrounding GOC is inadequate, and that at 9% of MET calls, MET doctors are involved in discussions surrounding treatment limitations. This suggests that further education and training is required for doctors working in inpatient care, including those who staff the MET.© 2019 Royal Australasian College of Physicians.

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