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Prioritizing Patient Wishes with the Goal Concordant Care Lab (2025-2026)

The Prioritizing Patient Wishes with the Goal Concordant Care Lab team explored common challenges in caring for those experiencing serious illnesses. 

Patients who are facing a serious illness must make numerous complex healthcare decisions that will determine what treatment they receive, what their quality of life will be and how long they will survive. Too often, patients and their families must make these decisions without adequate communication about their hopes, fears, values and goals. The result is that many patients receive more treatment than they would like, or treatment that is intended to prolong survival when their goals are actually to maximize comfort and preserve their quality of life.

The team worked with the Goal Concordant Care Lab, a collaboration between Duke Health and Duke University, led by Duke Palliative Care, to examine how health systems can better understand patient values and propose innovative ways to align medical care with those goals.

Team members engaged with expert-led panels featuring clinicians, researchers and caregivers to discuss ways in which communication gaps, structural barriers and clinical norms can contribute to care that is misaligned with patient wishes. Drawing on insights from mentorship, course discussions and readings, team members translated complex problems into short innovation pitches proposing conceptual solutions to challenges in serious illness care.

The final pitches reflected a wide range of approaches, including electronic health record triggers to prompt goals‑of‑care conversations, decision-support tools to reduce cascading drug prescriptions, strategies to mitigate bias in neurocognitive testing and patient‑facing tools to address financial concerns. These proposals demonstrated how thoughtful design, communication strategies and system-level interventions might better center patient values in clinical decision‑making.

Timing

Fall 2025 – Spring 2026

Team Outputs

Prioritizing Patient Wishes with the Goal Concordant Care Lab (Interactive display at the Fortin Foundation Bass Connections Showcase, April 15, 2026)

Innovating Serious Illness Care Around What Matters to Patients (Team profile)

Pitches proposing ways to improve goal-concordant treatments for seriously ill patients

See earlier related team, Developing a Roadmap for Goals of Care Conversations at Duke (2024-2025).

Team Leaders

  • David Casarett, School of Medicine: General Internal Medicine, School of Medicine: Geriatrics
  • Erin Eckert, School of Medicine: Geriatrics
  • Kiira Lyons, School of Medicine: Geriatrics

Undergraduate Team Members

  • Hannah Auddino, Neuroscience (BS)
  • Meghna Katyal, Biology (BS)
  • Sitara Kumar, Biology (BS)
  • Clare Lee, Psychology (BS)
  • Kailynn Oliver, Evolutionary Anthropology (BS)
  • Yurika Sakai, Biology (BS)
  • Lauren Tolbert, Biology (AB)
  • Ashmi Trivedi, Neuroscience (BS); Global Health (AB2)
  • Yuxuan Zhou, DKU-Interdisciplinary Studies (BS)

Team Contributors

  • Deepshikha Ashana, School of Medicine: Pulmonary, Allergy and Critical Care Medicine
  • Sharron Docherty, School of Nursing
  • Margaret Johnson, School of Medicine: Neurosurgery
  • Brystana Kaufman, Fuqua School of Business: Health Sector Management Program, School of Medicine: Population Health Sciences
  • Jessica Ma, School of Medicine: General Internal Medicine, School of Medicine: Geriatrics
  • Katherine Ramos, School of Medicine: Psychiatry and Behavioral Sciences, School of Medicine: Psychiatry: Behavioral Medicine
  • Kristin Schroeder, School of Medicine: Pediatrics: Hematology-Oncology