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Family Meeting Note for Goals of Care
Rough notes from a family meeting turned into a goals of care note: who attended, what was said, what was decided and what happens next.
River's family meeting note turns what you scribbled during a goals of care conversation into the note the rest of the team will rely on. Paste your notes, however rough, and get a structured note: who attended and who holds decision-making authority, what was said about the illness and prognosis, what matters most to the patient, the decisions made, where people disagreed, and the plan. Statements are attributed to the person who made them, and nothing is added that the meeting did not produce.
Unlike the templates that rank for this search, this keeps the conversation's shape instead of flattening it into checkboxes. The difference between a patient's own stated wish, a proxy's report of it and a relative's hope is the most important thing in the note, and a blank labelled family wishes erases it. Disagreement is recorded as disagreement. A decision that was discussed but not made stays open, with the date it will be revisited, rather than drifting into the plan as settled.
This is for hospitalists, intensivists, palliative care teams and oncologists, and for the social workers, chaplains and nurses who sit in these meetings. Use it the same day, while the wording is fresh. The note then feeds what follows. A transition to hospice or a nursing facility needs a discharge summary that carries the decisions, and a specialist asked to weigh in gets a referral letter naming the question the family is waiting on.
Who said it matters as much as what was said
Structure helps families, not only the record. In a randomized trial in the New England Journal of Medicine, relatives of patients dying in 22 French intensive care units had a proactive end-of-life conference, with more time for them to talk, plus a bereavement brochure. At 90 days they reported fewer symptoms of post-traumatic stress than relatives given the usual conference, 45 percent against 69 percent. The note is where that conference survives the shift change, so record what the family asked as well as what they heard.
Decision-making authority needs its own line. Record whether the patient took part and had capacity for this decision. If not, record who is speaking for them and on what basis: an appointed health care agent, a court-appointed guardian, or a relative recognized under your state's surrogate law. Then separate what the patient said themselves, what the surrogate reports the patient wanted, and what the surrogate wants. Those are three different kinds of evidence, and the next clinician needs to tell them apart.
If the conversation counts as advance care planning, the note may also support billing for it. Medicare's advance care planning guidance asks the note to show that the discussion was voluntary, explain the advance directives discussed, name who was present and record the time spent, with at least 16 minutes for the first code. So write the time down during the meeting. A note that says only that goals were discussed supports neither the claim nor the next clinician.
How it works
Paste your notes
Whatever you wrote during or after the meeting, rough fragments included, with identifiers removed if needed.
Choose the format
A note for the medical record, a plain summary for the family, or both together.
Get the note
Attendees, authority, what was said and decided, open questions and the plan, with gaps marked.
Follow through
Ask for the order changes as a checklist, or a draft letter to the family.
What you get
- Attendees with roles and relationships, and who holds decision-making authority and on what basis
- What the patient said, what the surrogate reports and what relatives want, kept clearly apart
- The illness and prognosis as they were explained, in the words the team actually used
- Decisions made, decisions deferred with a date to revisit, and disagreements recorded as disagreements
- A plan with owners: orders to change, consultations to request and the next meeting date
- An optional plain-language summary for the family, written without abbreviations or medical shorthand
Common questions
Can I paste real patient details?
Check your organization's policy before you do. Where your organization has a business associate agreement with River, its terms apply. Otherwise use roles instead of names, such as wife and health care proxy, and leave out record numbers and dates. The note keeps those roles and adds placeholders for names, so you can complete it inside your own record system.
Does it record a code status change?
It records what was decided and who agreed, in the words of the meeting, and lists the order change as a task for the team. It does not treat a discussion as an order. If your notes say a decision was discussed but not finalized, the note says so and gives the date it will be revisited, rather than presenting it as settled.
What if the family disagreed?
Then the note says who held which view, in their own terms where you recorded them, and what was done about it: another meeting, more information, or an ethics or palliative care consultation. Smoothing a disagreement into a consensus is one of the commonest ways these notes mislead the next team, so it never does that.
Can it write something for the family to keep?
Yes. Choose the family summary and it writes a short letter in plain words: what the team explained, what the family said matters most, what was decided and what happens next, with a placeholder for a name to call. It includes only what was said in the meeting, so nothing reaches the family in writing for the first time.
How soon should the note be written?
The same day, ideally before the team disperses. The exact wording people use about prognosis and about what the patient would want fades fast, and that wording is what the next clinician needs. If several clinicians were present, one person writes it and the others check that their part is recorded the way they said it.
Where does the plan go after the meeting?
Into the orders, the care plan and the next handoff. The note lists each task with an owner. For goals and reviews that run across a whole team, a treatment plan documentation template keeps them in one place, and if the patient leaves the hospital, the decisions belong in the discharge summary as well.
Sources
Built by
Chandler Supple
Co-founder & CEO, River
Chandler has spent the last six years working in AI, building tools for millions of users and Fortune 100 companies. In 2025, he co-founded River to build a new kind of operating system for AI agents.
Family Meeting Note for Goals of Care
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