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Written by: Darlene D'Altorio-Jones (1959-2015) on Monday, July 11, 2011 Posted in: Inpatient Rehab

Goal – an objective desired to achieve.

For most in the rehabilitation world, it defines the level we have set as clinicians in conjunction with the patient to meet identifiable progress to the extent necessary to fulfill greater independence in a skill.

A skill important enough to warrant expert intervention to retrain, accommodate or overcome with the varied knowledge set we possess to fulfill that need. So, we ask, is it a barrier to discharge (if inpatient), or is it a significant roadblock (if outpatient), that it presents a key reduction in the ability to care for oneself?  If so, it’s an impairment.

Yet I see clinicians struggle every day with how to write a goal. A measurable statement that directs a specific action to achieve. Statements like “ongoing”, don’t tell me how close I am to achieving the distinct level that was set.  A reduction in the burden of care is another statement that is meaningless – we know that is what we are working towards!  Yet these are statements that are seen in progress towards goals and for a goal itself.

Impairments require tactical resolution and when more than one clinician is working towards the resolution, attainment guidance is a common language for where we’re headed.

You can’t say ‘”let’s go” if you aren’t telling me where to go or how to get there.  Goals are the same.  Tell me what needs to be achieved or expected as an outcome,  and as a clinician, depending on my specific skill sets, I will work my interventions to assist that patient towards attainment of that specific goal.

Clinicians of all sorts are in the business to solve impairments. If you are an interdisciplinary team, everyone must be on the same, not divergent, paths to resolution.  Therefore, writing the goal so that everyone knows what is expected as the result of interventions to impairment is critical.

Write a goal that is specific and measurable and that will enable the patient and other clinicians to  know exactly how close you are in updates towards progress and to know when the desirable outcome has been met. Goal achievement has always been the basis for clinical services but now more than ever, the measurement of those services must be specifically understood so that rehabilitation effectiveness makes it readily apparent that rehabilitation of all levels must be included in the plans for healthcare reform.

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