Putting "what matters to you?" into practice: a focused team-based ethnographic study on goal-oriented care

Area of Science:

• Healthcare delivery
• Primary care research
• Integrated care models

Background:

• Person-centred integrated care (PC-IC) emphasizes patient values.
• Goal-oriented care (GOC) aligns medical interventions with patient priorities.
• Limited understanding exists on GOC implementation and required provider competencies.

Purpose of the Study:

• To explore how primary care providers implement GOC in their daily practice.
• To identify the specific competencies needed for effective GOC enactment.
• To inform future training and competency development for GOC.

Main Methods:

• A team-based ethnographic approach combining observations and interviews.
• Purposive sampling of primary care providers with interprofessional GOC training.
• Thematic analysis to identify GOC behaviors and underpinning competencies.

Main Results:

• GOC enactment relies on contextual, relational, and reflective competencies.
• Providers demonstrated contextual awareness by linking care to patient experiences and goals.
• Relational trust was built through open communication, fostering shared decision-making.
• Reflective competence involved reassessing care based on patient goals, assumptions, and team input.

Conclusions:

• Strengthening reflective competencies is crucial for primary care provider training.
• Supporting providers in reflecting on responsibilities and assumptions is vital.
• Reflective capacity is essential for embedding GOC and aligning care with patient priorities.