In September 2020, the ADCC launched a collaborative project called the Improving Goal Concordant Care (IGCC) Initiative. Collectively, our cancer hospitals have embraced the vision that all patients with cancer and their families should receive care that aligns with their values and unique priorities.

To realize this vision, we believe that primary oncology teams must take responsibility for timely initiation and ongoing conversations regarding goals of care with their patients. However, we recognize that oncologists need enhanced training and an enabling practice infrastructure to achieve reliable, effective, and efficient goals-of-care conversations.

The IGCC is a three-year initiative designed to address system gaps across our centers and to establish new expectations for when and how goals-of-care conversations occur. IGCC’s conceptual development was led by palliative care and oncology experts across our 10 cancer centers, and guided by patient and family advisors.

The IGCC core components are:

• A formal communications skills training program for hematologists/oncologists and collaborating advanced practice professionals. Training must integrate one of the proven, existing programs for goals-of-care communications education, or adopt established key learning domains and rigorous training methods.
• Structured goals-of-care documentation in electronic health records, including a minimum set of structured fields and functionality to promote access and retrieval across providers and settings
• Expectations regarding the patients who are prioritized to receive goals-of-care discussions, and timing for communication
• An evaluation and measurement framework