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Life-Sustaining Treatment Decisions Initiative (LSTDI)

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The Life-Sustaining Treatment Decisions Initiative (LSTDI) is a national VHA quality improvement project that promotes personalized, proactive, patient-driven care for Veterans with serious illness by eliciting, documenting, and honoring their values, goals, and life-sustaining treatment decisions.

This innovation is scaling widely with the support of national stakeholders. See more scaling innovations.


January 2017, VHA National Center for Ethics in Health Care


5 successful


Quality Enhancement Research Initiative



  • Number of completed LST templates; % of seriously ill (e.g., CAN score 95 and above) patients with existing LST plan
  • Goal concordant care at end of life

Diffusion tracker

Does not include Clinical Resource Hubs (CRH)