title: The 4-h target: an example of destructive goal pursuit?
abstract: Destructive goal pursuit (DGP) is the situation in which goal setting becomes dysfunctional, leading to impaired performance. This paper considers the 4-h target against the model of DGP and finds many similarities. It does not attempt to provide a critique of the model, nor does it seek to review all the effects of the 4-h target. The need for multiple goals, for all domains of quality to be addressed in these, and for a focus on effective team working and team learning are emphasised. Targets, in a way analogous to drugs or other 'therapeutic' interventions, have the potential to cause adverse effects as well as positive ones. A greater understanding will help ensure their overall impact is as beneficial as positive.
authors.affiliation: Emergency Department, University Hospital of North Durham, North Road, Durham DH1 5TW, UK. richard.hardern@cddft.nhs.uk
authors.forename: Richard David
authors.initials: RD
authors.lastname: Hardern
mesh_terms: D003695:Delivery of Health Care / Q000592:standards*; D004632:Emergency Medical Services / Q000458:organization & administration*; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D013222:State Medicine; D013997:Time Factors; D006113:United Kingdom