Pilot of a person-centred, interdisciplinary approach to goal setting in Ireland’s National Rehabilitation Hospital: a study protocol

Vollständiger Abstract

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Background Research has emphasised the value of a person-centred, interdisciplinary team (IDT) approach to structured goal setting in rehabilitation; yet these approaches are not consistently implemented in clinical practice, limiting the effect that goal setting can have on rehabilitation. The introduction of a new IDT, person-centred goal-setting process to Ireland’s National Rehabilitation Hospital (NRH) offers an opportunity to gain insight into barriers to implementing and normalising IDT goal setting in complex, specialist rehabilitation services. This process was developed prior to, and independently of, the current evaluation by the hospital’s quality improvement (QI) team; this protocol concerns the evaluation of its pilot implementation. Method The study was co-designed by embedded academic researchers and knowledge stakeholders, including the QI team responsible for introducing the new process and two former patients. A mixed-methods approach will capture patient and staff experiences and perspectives of the new process and, secondarily, pilot the feasibility of quantitative outcome measures ahead of a possible future hospital-wide evaluation. Data will be collected by embedded researchers using self-report measures and qualitative interviews with staff and patients. Measures include the Client-Centredness of Goal Setting scale (C-COGS), CollaboRATE, the Interprofessional Socialization and Valuing Scale (ISVS-9B), and the Normalization Measure Development questionnaire (NoMAD), capturing person-centredness of goals, shared decision-making, interprofessional socialisation and process normalisation. Quantitative data will be analysed using descriptive and, where appropriate, inferential statistics; qualitative interview data will be analysed using reflexive thematic analysis. Discussion & Conclusion The study aims to provide a holistic view of patient and staff experiences of the goal-setting process and to identify challenges and potential solutions to implementation within this context. Findings will inform further implementation within the hospital and contribute to rehabilitation practice around implementing IDT goal setting, adding an Irish perspective to the existing rehabilitation goal-setting literature.