Forum Session

Goal-Oriented Chronic Care: Defining Concepts and Developing Tools
September 25, 2015


Lisa Sprague, MBA


Health care in the United States has long followed a problem-solving model: identify what is wrong and set out to fix it. This approach works well in acute care, where the problem, the course of treatment, and the desired outcome are most often readily identifiable. In chronic care, which accounts for an increasingly large proportion of health care services, it may not be easy to prioritize either problems or appropriate treatments. Among the elderly, people with disabilities, and special needs children, multiple chronic conditions are common, and often can at best be managed rather than cured. Some physician leaders champion a different approach, known as goal-oriented care, under which treatment decisions are founded on a patient's expressed goals and success is measured by the extent to which these are attained. Some organizations have started to pilot goal-oriented care, and have recognized that it represents a culture change for both providers and patients. This Forum session considered several efforts to implement goal-oriented care, the factors critical to its adoption and operation, and the challenges facing a health care system that is trying to become more patient-centered and to deliver higher-quality care.


Mary Tinetti, MD (bio)
Gladys Crofoot Professor of Medicine (Geriatrics)
Chief, Geriatrics
Yale University

David Reuben, MD (bio)
Director, Multicampus Program in Geriatrics Medicine and Gerontology
Chief, Division of Geriatrics
Center for Health Sciences
University of California, Los Angeles

Richard Allman, MD (bio)
Chief Consultant
Office of Geriatrics and Extended Care Services
U.S. Department of Veterans Affairs

Christine Cassel, MD (bio)
President and Chief Executive Officer
National Quality Forum

Related Materials

David B. Reuben and Mary E. Tinetti, "Goal-Oriented Patient Care – An Alternative Health Outcomes Paradigm," The New England Journal of Medicine, 366, no. 9 (March 1, 2012): pp. 777-779.

↑ back to top

Browse Topics Side ArrowDown Arrow