What is goal setting?
“The identification of and the agreement on a behavioural target which the patient, therapist or team will work towards over a specified period of time” (RCP 2008). It is a fundamental component of rehabilitation and recommended good practice (SIGN 118 2010).
What is patient centred goal setting?
These are goals that are led by the patient. The clinical team and the patient identify the patient’s primary rehabilitation aims with respect to their recovery and functional ability and from this patient relevant goals are identified and documented in a narrative patient friendly style. The goals are determined by the patient. Whilst the team can guide the patient if a patient does not identify areas as areas they need to work on then they cannot/ should not be documented as the patient’s goals.
What are therapeutic/intervention goals?
These are goals that are totally identified and set by the clinical team. The patient may be aware of the goals but does not directly contribute. The goals reflect what the professional team anticipates will be the patient’s potential level of functional ability. They relate to activities that the team deems to be important for the patient’s rehabilitation and are documented in a more clinical/medical intervention style. By setting and documenting therapeutic goals it ensures that tasks happen in a timely manner. Therapeutic/intervention goals can often occur alongside patient- centered goals e.g. the team has identified that they need to get Mr Rowan more involved in Alice’s care. Whilst this is not Alice’s specific goal in order to make sure that this occurs the team will need to co-ordinate and manage this. The therapeutic goal set for two weeks time could therefore be:-
‘Mr. Rowan will have attended therapy and nursing sessions and be competent transferring his wife in and out of a chair and will have begun assisting her in the toilet with supervision of one staff’.
What if a patient cannot do patient centred goal setting?
For some patients with marked cognition and comprehension problems patient centred goal setting is not appropriate. In this situation intervention/therapeutic goals are more appropriate. It is important to constantly review if the patient’s abilities have changed so that should they become capable of patient centred goal setting that they get offered that opportunity. Patients with expressive difficulties with the correct assistance can still set goals.
The theory is all very well but how can I put into clinical practice?
Page last reviewed: 01 May 2020