David A Gruenewald1, Michelle Gabriel2, Dorothy Rizzo2, Carol A Luhrs2. 1. David A. Gruenewald is medical director, Palliative Care and Hospice Service, Geriatrics and Extended Care Service, Veterans Affairs Puget Sound Health Care System, and associate professor of medicine, Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington. Michelle Gabriel is director of process improvement, Office of Quality, Safety and Value, Veterans Affairs Palo Alto Health Care System, Palo Alto, California. Dorothy Rizzo is hospice and palliative care coordinator, Geriatrics and Extended Care Service, Salem Veterans Affairs Medical Center, Salem, Virginia. Carol A. Luhrs is chief, Hematology/Oncology Section, Department of Medicine, Veterans Affairs New York Harbor Healthcare System; director, Veterans Affairs Comprehensive End of Life Care Implementation Center; and associate professor of clinical medicine, Hematology/Oncology Division, Department of Medicine, State University of New York at Brooklyn, Brooklyn, New York. david.gruenewald@va.gov dgruen@uw.edu. 2. David A. Gruenewald is medical director, Palliative Care and Hospice Service, Geriatrics and Extended Care Service, Veterans Affairs Puget Sound Health Care System, and associate professor of medicine, Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington. Michelle Gabriel is director of process improvement, Office of Quality, Safety and Value, Veterans Affairs Palo Alto Health Care System, Palo Alto, California. Dorothy Rizzo is hospice and palliative care coordinator, Geriatrics and Extended Care Service, Salem Veterans Affairs Medical Center, Salem, Virginia. Carol A. Luhrs is chief, Hematology/Oncology Section, Department of Medicine, Veterans Affairs New York Harbor Healthcare System; director, Veterans Affairs Comprehensive End of Life Care Implementation Center; and associate professor of clinical medicine, Hematology/Oncology Division, Department of Medicine, State University of New York at Brooklyn, Brooklyn, New York.