From theory to an understanding on how primary care providers and managers operationalize goal-oriented care in three international primary care settings
Dagje Boeykens, Patricia De Vriendt, An De Sutter, Agnes Grudniewicz, Lies Lahousse, Peter Pype, Carolyn Steele Gray, Dominique Van De Velde, Pauline Boeckxstaens
Keywords: Primary care, goal-oriented care, person-centered care, primary care providers, chronic care
Background:
Goal-oriented care (GOC) is one of the suggested strategies for person-centered integration of care. In GOC, care is explicitly focused on the patients’ personal goals. To make GOC more applicable, it is important to build an understanding on how it should be provided in practice. Therefore, it is vital to learn from primary care providers and managers on how they operationalize GOC.
Research questions:
How do primary healthcare providers and managers operationalize GOC?
Method:
Primary care providers and managers were recruited in different primary care settings in Ottawa (Canada), Vermont (USA), and Ghent (Belgium). A two-step approach of a deductive and inductive analysis was used to analyze the in-depth interviews. Firstly, the theoretical framework that emerged from the concept analysis on GOC was used for the deductive analysis to validate the literature. Secondly, an inductive thematic analyses was performed to expand the theoretical knowledge with insights from practice. Interviews were audio taped and transcribed verbatim.
Results:
The deductive analysis was conducted using the theoretical framework of GOC consisting the process of goal-elicitation, goal-setting, and goal-evaluation underpinned by the patients’ needs and preferences and patients' context. All elements could be identified in practice, but not in such in a linear way as emerged from literature. This emphasized the dynamic character of GOC. The inductive analysis revealed three main themes: 1) involving the patients, 2) interprofessional collaboration, and 3) the use of tools or guidance.
Conclusions:
Besides the validation of the literature, we learn from practice that professionals made use of tools to support goal-elicitation, goal-setting, and to prepare interprofessional meetings. All this with the overall aim to encourage patients to actively take part in their care.
Points for discussion:
#5