A framework for patient goals that guides providers in the process of goal oriented care

Context : Goal-oriented care implies a shift from disease-oriented care towards care that puts the patient ‘s goals first. Even though many health care providers are in favour of goal-oriented care, they struggle to translate the concept into a tangible process of care.

Objective : The purpose of this study is to develop a framework for patient goals that guides professionals in the process of goal-oriented care.

Study Design: First, a review on the international peer reviewed literature on treatment goal-setting for complex patients was conducted to identify different frameworks for goal setting. Second, a document analysis was performed on the content and on the related documents of different tools for goal-oriented care that have been developed in Flanders. As a third step, twelve primary care professionals from different disciplines were trained to engage in goal-elicitation encounters with their patients. Twenty-five of these encounters were recorded on audio or video and analysed thematically to identify how goals were identified and translated to care planning.

Results : An integration of the literature search, the document analysis and 25 goal-elicitation encounters led to the development of a framework for patients’ goals consisting of four key elements : values, patient life goals, care goals and care planning. Furthermore, four key questions and six building blocks for patient goals were be identified.

Conclusions : Using the results of this study, we developed a framework for patient goals that can support health care providers to engage in a reflexive process on the different types of goals in complex situations. The key questions identified in this study can be used by providers who want to talk with patients about the things that matter most to them. The building blocks of patient goals can help professionals gain further insight into patient goals.