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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
PubMed

Insights

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.
Abstract

Keywords:
family‐centred goal settingfamily‐centred practisegap measurementgoal setting

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