Is achievement of short-term goals a valid measure of patient progress in inpatient neurological rehabilitation?
OBJECTIVE
To determine whether the use of short-term goal setting is effective in monitoring patient progress, with regard to achievement of rehabilitation goals for discharge and predicted length of hospital stay.


METHODS
A prospective observational cohort study.


METHODS
An inpatient rehabilitation unit co-located with a large tertiary teaching hospital.


METHODS
Consecutive cases admitted to rehabilitation with a neurological condition and a planned length of stay of three weeks or longer.


METHODS
Discharge and short-term goals and predicted length were set in the initial team meeting. Goals were set, and achievement scored, in the domains of health, social functioning, communication and cognition, mobility and activities of daily living (ADLs) and a composite goal of global function. Actual length of stay and discharge destination were recorded.


RESULTS
Data from 53 consecutive cases were examined, with 45 cases returning home. The median length of stay was 49 days (interquartile (IQ) 30-74). Significant correlations (P<0.05) were demonstrated between short-term goal achievement and discharge goals for continence (rho = 0.62), transfers (rho = 0.53), personal activities of daily living (rho = 0.47) and global function (rho = 0.62). For those that returned home, there were significant correlations (P<0.05) between adherence to predicted length of stay and achieving their initial goals in transfers (rho = 0.44), walking (rho = 0.51) and global function (rho = 0.55).


CONCLUSIONS
Short-term goal setting is a valid measure of patient progress in inpatient neurological rehabilitation and can be used to identify patients who are not progressing as anticipated, facilitating review of the rehabilitation plan.
Black
Susan Jane
SJ
Physiotherapy Department, St Vincent's Hospital, Fitzroy, Victoria, Australia. Susie.Black@svhm.org.au
Brock
Kim Alison
KA
Kennedy
Genevieve
G
Mackenzie
Meaghan
M
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D005242:Fecal Incontinence; D006040:Goals; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D009422:Nervous System Diseases / Q000534:rehabilitation*; D017063:Outcome Assessment, Health Care; D010360:Patient Transfer; D011446:Prospective Studies; D014549:Urinary Incontinence