Implementation of best practice goal-setting in five rehabilitation services: A mixed-methods evaluation study

Area of Science:

• Rehabilitation Medicine
• Healthcare Implementation Science
• Clinical Practice Improvement

Background:

• Effective clinical goal-setting is crucial for successful rehabilitation outcomes.
• Variability in goal-setting practices can hinder patient progress and satisfaction.
• A structured approach is needed to enhance the key elements of clinical goal-setting.

Purpose of the Study:

• To implement and evaluate a package designed to enhance clinical practice goal-setting.
• To assess the impact of the implementation package across five diverse rehabilitation services.
• To identify factors influencing the success of goal-setting interventions in rehabilitation settings.

Main Methods:

• A participatory action research approach guided by the Knowledge to Action framework was employed.
• Medical record audits and structured client interviews were conducted pre- and post-implementation (12 weeks).
• Data were collected at baseline, immediately after implementation, and at a 3-month follow-up to assess sustained effects.

Main Results:

• Two sites significantly improved common goal focus and client receipt of goals post-implementation.
• Four sites enhanced client action planning, feedback, and review processes.
• While common goal focus was maintained at follow-up, specificity of goal-setting decreased across all sites.

Conclusions:

• The implementation package demonstrated success in enhancing specific elements of the clinical goal-setting process.
• The manner in which the implementation package is adopted and integrated within clinical teams significantly influences outcomes.
• Further research is needed to optimize implementation strategies for sustained improvements in goal-setting practices.