Aim
To audit compliance and outcomes with a limitation of medical treatment instrument entitled ‘Goals of Care Plan’ (GOCP) over the course of a final admission to the RHH, and thereby assess its role in the recognition of dying.

Method
Retrospective analysis of the Digital Medical Record (DMR) of all deceased patients at the RHH over the six-month period 1/1/2013 – 30/6/2013.

Results
There were 352 deaths. 290 (82.4%) patients had a completed GOCP and 62 (17.6%) did not. After exclusion of sudden unexpected deaths and rural campus beds, the compliance rate for GOCP completion was 94.5%.
Patients are assigned to one of four categories: curative with no limitations (A), curative with limitations (B), palliative (C) and terminal (imminently dying) (D). Final GOCP category was either C or D for 86% of the deceased patients studied.
74% of forms were completed on the day of admission and 83.5% within 48 hours. 78% of patients assigned to category D died within 72 hours.

Conclusion
Compliance with completion of the GOCP was high. There was timely recognition of the imminently dying patient, and the GOC framework prompted appropriate limitations to medical treatment escalation, and deployment of necessary and appropriate palliative and terminal care.