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Correction to: Implementing goals of care conversations with veterans in VA long-term care setting: a mixed methods protocol

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Implementation Science201813:29

  • Received: 1 February 2018
  • Accepted: 1 February 2018
  • Published:

The original article was published in Implementation Science 2016 11:132


The authors would like to correct errors in the original article [1] that may have lead readers to misinterpret the scope, evidence base and target population of VHA Handbook 1004.03 “Life-Sustaining Treatment (LST) Decisions: Eliciting, Documenting, and Honoring Patients’ Values, Goals, and Preferences”.

The original article [1] indicated that the target population for the practice changes described in the policy was all Veterans. In fact, the primary aim of the policy initiative is to ensure that the goals, values and life-sustaining treatment decisions of Veterans at high risk for a life-threatening event within the next 1–2 years, will be proactively elicited, documented, and then honored in the delivery of their care.

The original article [1] stated that goals of care conversations (GoCC) would be conducted with Veterans and their family members. Veterans with decision-making capacity will determine how or if they wish to have their significant others engaged in GoCC and life-sustaining treatment decisions. GoCC and subsequent life-sustaining treatment decisions for Veterans who lack capacity will occur with their duly authorized surrogate or health care agent in accordance with their advance directive. If a Veteran lacks capacity and does not have a surrogate, the policy describes a multidisciplinary process for decision making.

The original article did not note that all components of the VHA policy initiative were extensively field tested by the VA National Center for Ethics in Health Care at 4 VA medical centers that served as demonstration sites over a two year period. To date, over 7000 seriously ill Veterans have had their GoCC proactively elicited and documented on a standardized progress note template and order set located in the electronic health record.



Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

Authors’ Affiliations

Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
University of Michigan Medical School, 300 N. Ingalls Street, Room 1161-I, Ann Arbor, MI 48109-5423, USA
Corporal Michael J. Crescenz VAMC, Philadelphia, PA, USA
School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
Canandaigua VAMC, Canandaigua, NY, USA
University of Rochester Medical Center, Rochester, NY, USA
Eastern Colorado Health Care System, Denver, CO, USA
School of Medicine, University of Colorado Anschutz Campus, Denver, CO, USA
Brown University School of Public Health, Providence, RI, USA
VA Palo Alto Health Care System, Palo Alto, CA, USA
Stanford University School of Medicine, Stanford University, Palo Alto, CA, USA
Puget Sound Health Care System, Seattle, WA, USA


  1. Sales AE, et al. Implementing goals of care conversations with veterans in VA long-term care setting: a mixed methods protocol. Implement Sci. 2016;11:132. ArticlePubMedPubMed CentralGoogle Scholar


© The Author(s). 2018