Through education, resource development, support and advocacy, Goals of Care’s mission is to ensure that healthcare providers, patients and caregivers have the information, resources, training and tools they need to facilitate discussions that result in a care plan that aligns treatment with the patient’s goals of care.
Who We Are
Goals of Care (GOC) is a 501(c)(3) nonprofit with strong roots to New Jersey and a deep commitment to improving end-of-life care for New Jersey seniors. Our vision is to to create a standard of care for NJ where people explore their wishes for care towards the end of life, express these wishes, and have their wishes honored. Our goal is to transform the care of NJs elderly and seriously ill patients so that their medical care is aligned with their individual preferences so that people get the care they need and no less, and the care they want and no more.
Dialogue that is genuinely patient-centered places demands on both sides of the conversation. Patients and surrogate decision-makers must fully understand the medical conditions, prognoses, and treatment options; health care providers must be able to communicate prognoses in a culturally sensitive and health-literate manner and help patients articulate their personal goals. Our key objectives are to
- Create awareness of the benefits of advance care planning.
- Help Health Care Professionals (HCPs) engage in conversations with patients about their diagnosis, prognosis, goals of care and treatment preferences. To educate and train HCPs to lead conversations with patients and caregivers where they receive the information they need to make fully informed decisions and have the opportunity to document their treatment wishes.
- Facilitate advance care planning discussions and to ensure that these conversations happen seamlessly and continually over the course of a person’s life span, appropriately triggered by life events and changes in medical condition.
- Help establish systems that make conversations about treatment goals and options a reliable, consistent part of care and to help ensure information about patient preferences are documented and easily accessible when needed.
- Support efforts to address public policy and provider reimbursement for these conversations and to facilitate the ability to share documentation of preferences across the care continuum.
To meet these objectives, Goals of Care has developed a Four-Step Model © in which conversations between the medical team and the patient’s decision-makers are structured around the following questions:
- What is the Diagnosis?
- What is the Prognosis?
- What are the patient’s Goals of Care in the context of this Prognosis?
- What Treatment options will achieve these goals?
Doctors are well-trained in the traditional two-step model of confirming the diagnosis (step one) and prescribing treatment (step two), but the two-step model lacks the key elements of communicating the prognosis and eliciting the patient’s goals in light of that prognosis. Our Four-Step Model is a unique tool that gives both sides of the conversation structure and responsibility. Goals of Care is at work on a number of initiatives to make this new Four-Step Model an integral part of medical training and practice.
Additionally, Goals of Care has played a vital role in the design and implementation of the New Jersey POLST form (Practitioner Orders for Life Sustaining Treatment), which has become a key tool for improving doctor-patient communication and ensuring that treatment decisions stay focused on the patient’s goals.
To meet our strategic goals and fulfill our mission, we are currently engaged in the following projects:
- On our website, we offer “The GOC Learning Center,” which comprises a series of brief educational videos for patients and surrogate decision makers. These “Learn More About…” videos explain the use of the NJ POLST form and even help viewers prepare a letter to their doctors requesting a conversation about the NJ POLST form. Additionally, decision-makers may learn about the Four-Step Model © approach to help navigate through difficult medical decisions.
- GOC actively promotes the Four-Step Model and the NJ POLST form through its website and through public-speaking engagements by GOC Medical Director David Barile.