Goal setting in Clinical Practice: A physiotherapy perspective

Applied Physiotherapy 203March 2012

Individual activity

Think about your life as it is right now. For once you are allowed to be ambitious. Now write down two particular things, either personal or professional you would like to achieve, experience or have one day.

Some people’s idea of a goal....

Is this a realistic goal?

Using the SMART principle for setting goals

• Utilised within the business world for reaching target (and taking over the world)

• The medical world has adopted this principle effectively

• It’s valid within a variety of contexts (not just business and medical world, but also to your own life)

Acronym S.M.A.R.T

• Specific (Significant, stretching or simple)

Measurable

Could also be meaningful, motivational and manageable

Agreed action plan to achieve goals

• Agreed plan: should be clear and within the scope of the profession / attainable goals

Could also be appropriate, attainable and achieveable

Relevant

You also wouldn’t agree that a 90 year old patient with arthritis to run 4 laps around a 400m track

Time-bound

• Time-oriented, time-specific

Activity

Review your two goals that you have set in the beginning of the lecture and assess it against the SMART principle.

• Identify the limitations and share it with your group

How to apply this principle

You were asked by the ward physiotherapist to treat a patient presenting with +++ secretions

in the lower lobesObjective: Optimise lung function by removing

secretions from the lower lobesS: Remove secretions from the lower lobesM: Auscultation to assess and re-assessA: Alternative side lying, percussions, shakings,

vibrations, ACBT etc

Case study cont.

• R (relevance): Improve lung volumes and reduce lung collapse

• T: treatment twice a day for three days (depending on the recovery and removal of all secretions)

Application of SMART goals in long term patients

Your patients had been in hospital with HIV/Aids and TB. For the last three week she did not mobilise due to extreme fatigue and shortness of breath

Setting objectives• Define short and long term goals• Identify short and long term goals• Use SMART principle for both short and long

term goals

Example of short term goal

• Relieve breathlessness

Example of long term goal

• Improve endurance and mobilise for longer distances

Q & A