A systematic-narrative review of goal-setting guidelines in workers' compensation rehabilitation in Australia

Goal setting is a core component of return-to-work rehabilitation in Australia. Various treatment guidelines have been developed and are regulated independently by each jurisdiction's workers' compensation authority. However, the extent to which these guidelines are consistent from a goal-setting perspective is unclear. Therefore, this study aimed to review all goal-setting guidelines for health professionals delivering services within workers' compensation schemes in Australia.

A systematic-narrative review was conducted that searched academic and grey literature databases, web search engines, and workers' compensation authorities' websites, identifying 26 goal-setting guidelines across all Australian states/territories.

The analysis indicated that 58% of guidelines involved specific, measurable, achievable, relevant and timed (SMART) goal principles to some extent. Specifically, 35% of guidelines expected health professionals to only set SMART goals, 19% expected goals to include one or more of the SMART principles and 4% included guidance for multiple goal types. The SMART acronym was inconsistently conceptualised in 22% of guidelines that included this approach. Additionally, 42% of guidelines did not specify any goal type. There were also inconsistencies in the extent to which health professionals were expected to adhere to guidelines; recommendations regarding patient involvement in the goal-setting process; the required focus of rehabilitation goals; and their basis in goal-setting research.

This study suggests that goal-setting guidelines for return-to-work rehabilitation in Australia are inconsistent and primarily based on SMART goal principles. These findings highlight potential issues for health professionals supporting injured workers, and indicate that more evidence-based and consistent goal-setting guidance may achieve better outcomes in workers' compensation.