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Measuring Adherence to Family-Centred Goal Setting in Paediatric Rehabilitation: A Retrospective Chart Review
Armaghan Dabbagh1,2, Shauna Kingsnorth1,2,3, Joanne Maxwell1,2,3
1Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada.
Journal of Paediatrics and Child Health
|June 3, 2026
Summary
Family-centred goal setting (FCGS) in paediatric rehabilitation shows 60% adherence, with variations across categories. This study developed a tool to measure FCGS implementation, highlighting areas for improvement in pediatric brain injury units.
Area of Science:
- Pediatric Rehabilitation
- Neuroscience
- Health Services Research
Background:
- Family-centred goal setting (FCGS) is crucial for effective pediatric rehabilitation outcomes.
- Current implementation levels of FCGS in clinical practice remain largely unquantified.
- A standardized method is needed to assess adherence to FCGS principles.
Purpose of the Study:
- To develop and validate a Chart Audit Tool for measuring adherence to FCGS.
- To quantify the extent of FCGS implementation in a Canadian inpatient pediatric brain injury unit.
Main Methods:
- Retrospective chart review of 50 pediatric patients discharged in 2023.
- Development and refinement of a FCGS Chart Audit Tool assessing Partnership, Identification, and Agreement.
- Achieved 70% inter-rater reliability before independent chart audits.
Main Results:
- Overall mean adherence to FCGS was 60% across all reviewed charts.
- Category adherence rates: Partnership (68%), Identification (70%), and Agreement (66%).
- Significant variation in subcategory adherence, from 7% (family-centred tools) to 79% (goals supporting family priorities).
Conclusions:
- FCGS is implemented in pediatric rehabilitation settings, but with notable room for enhancement.
- The developed audit tool offers a reliable method for systematically measuring FCGS adherence.
- Findings provide a baseline for future research and quality improvement initiatives in pediatric rehabilitation.
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