[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-429122-105":59,"doc-detail-429122-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","goal-of-care-conversations-in-motion-using-system-dynamics-to-demonstrate-a-communication-priming-intervention","GOAL OF CARE CONVERSATIONS IN MOTION: USING SYSTEM DYNAMICS TO DEMONSTRATE A COMMUNICATION PRIMING INTERVENTION","","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.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/goal-of-care-conversations-in-motion-using-system-dynamics-to-demonstrate-a-communication-priming-intervention/429122/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/goal-of-care-conversations-in-motion-using-system-dynamics-to-demonstrate-a-communication-priming-intervention/429122.png","ImageObject",300,407,{"name":92,"@type":93},"MrHarris58","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why are goals-of-care conversations (GOCC) difficult to evaluate in serious illness?","Question",{"text":112,"@type":113},"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.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How does system dynamics contribute to modeling GOCC tools?",{"text":117,"@type":113},"System dynamics models healthcare interactions using components connected by feedback loops, delays, and non-linear relationships, making tool behavior visible within the broader system.",{"name":119,"@type":110,"acceptedAnswer":120},"What three key insights emerged from the causal loop diagram analysis?",{"text":121,"@type":113},"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.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},429122,1790901900,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":8,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":81,"preview_page_count":4},687212988360,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","990 Innovation in Aging, 2025, Vol. 9, No. S2  \nAbstract citation ID: igaf122.3340  \nGOAL OF CARE CONVERSATIONS IN MOTION: USING  \nSYSTEM DYNAMICS TO DEMONSTRATE A  \nCOMMUNICATION PRIMING INTERVENTION  \nChristi Lero, Washington University in St. Louis, St. Louis, Missouri, United States  \nHealth systems are challenged with how to best align treatment with patient values, particularly in the face of older adult patients and those with serious illness. As a result, tools have been developed to endeavor facilitation of goals-of-care conversations (GOCC), which is often seen as a clinical endpoint and research outcome during testing of such tools. However, rehospitalizations are a dynamic and somewhat usual feature of serious illness which remains uncaptured by current methodological approaches for GOCC development and testing. System dynamics is a method used to model systems and visualize interactions among its components via feedback loops, delays, and non-linear relationships. Using a recently published randomized clinical trial featuring a GOCC tool, system dynamics methods are applied using a causal loop diagram, demonstrating interactions of the tool within larger healthcare system and highlighting patterns that surface from its interactions. Three major insights emerged from this reconceptualization. First, there are multiple points at which a GOCC tool may interact with components of the healthcare system. Second, feedback loops reveal that GOCC are less likely to occur if they have already been completed and documented in the patient record. Third, GOCC are not ‘one and done.’ Rather, they need to be revisited at each change in condition or hospital admission. System dynamics offer insight into understanding complex interactions enabling us to predict how GOCC tools might behave within certain systems.","cbCaivnQrE23fSDW","https://ap.wps.com/l/cbCaivnQrE23fSDW","pdf",46679,"English","# Abstract\n## Problem: aligning treatment with patient values\n## System dynamics approach\n## Findings and implications","[{\"question\":\"Why are goals-of-care conversations (GOCC) difficult to evaluate in serious illness?\",\"answer\":\"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.\"},{\"question\":\"How does system dynamics contribute to modeling GOCC tools?\",\"answer\":\"System dynamics models healthcare interactions using components connected by feedback loops, delays, and non-linear relationships, making tool behavior visible within the broader system.\"},{\"question\":\"What three key insights emerged from the causal loop diagram analysis?\",\"answer\":\"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.\"}]","GOAL OF CARE CONVERSATIONS IN MOTION: USING SYSTEM DYNAMICS TO DEMONSTRATE A COMMUNICATION PRIMING INTERVENTION | PDF",1790648713]