GOAL OF CARE CONVERSATIONS IN MOTION: USING SYSTEM DYNAMICS TO DEMONSTRATE A COMMUNICATION PRIMING INTERVENTION

Sep 29, 2026

Health systems must align treatment with patient values, especially for older adults and those with serious illness, yet goals-of-care conversations (GOCC) are often treated as static clinical endpoints during tool evaluation. Rehospitalizations are dynamic and commonly occur, but they are not captured well by current GOCC development and testing approaches. System dynamics models interactions through feedback loops, delays, and non-linear relationships. Applied to a randomized clinical trial of a GOCC tool, the approach uses a causal loop diagram to show tool interactions within the healthcare system and reveals three insights.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages1

Reading Time3 min

AccessFree to download

Abstract

Problem: aligning treatment with patient values

System dynamics approach

Findings and implications

FAQs

Why are goals-of-care conversations (GOCC) difficult to evaluate in serious illness?

Current GOCC tool development and testing often treats GOCC as fixed endpoints, while rehospitalizations and clinical change are dynamic and commonly occur, so they are not well captured.

How does system dynamics contribute to modeling GOCC tools?

System dynamics models healthcare interactions using components connected by feedback loops, delays, and non-linear relationships, making tool behavior visible within the broader system.

What three key insights emerged from the causal loop diagram analysis?

First, GOCC tools can interact with multiple healthcare system components. Second, feedback loops show GOCC are less likely if already completed and documented. Third, GOCC should be revisited with each change in condition or hospital admission, not treated as one-time.

Sep 29, 2026

Uploaded by MrHarris58