Abstract
Introduction: Primary care is at the frontline of meeting the increasing demand for care and support for people with chronic and complex needs. Care is still often offered from a disease-oriented approach. However, for individuals with chronic and complex care needs, this approach tends to overlook the individual needs and values of persons. Goal-oriented care implies a shift from disease- and problem-oriented care towards care that starts from the patient’s goals and values. In Flanders different stakeholders have developed tools and strategies for goal-oriented care but, primary care providers who want to adopt goal-oriented care in practice report lack of overview and guidance on how to use and choose between these different strategies.
Method: In a co-creation process with the Flemish Institute for Primary Care, six innovators in goal-oriented care and the Flemish Patients Platform, the common ground and building blocks of goal-oriented care were identified and translated into a training package that can be implemented in primary care in Flanders. Both for persons with care needs, their informal caregivers and the providers, a training package was developed and piloted together with twelve early adopters and a patient representative.
Results: The co-creation process revealed that the implementation of goal-oriented care doesn’t merely depend on it’s functional integration through the use of tools, but also requires normative integration focused on the adoption of an attitude based on goal-oriented care. Because goal-oriented care requires close collaboration and partnership between the patient, their family caregivers and healthcare providers, training was developed for all of these stakeholders. Therefore, first of all a widely accessible online training was developed in which every interested citizen can learn about the principles on goal-oriented care. Second, an interprofessional training program trains and supports primary care providers to embrace goal-oriented care as a common philosophy of care that can be implemented in their local community. Also in this interprofessional training, all different stakeholders in the healthcare process actively interact with each other.
Conclusion: In this project, existing expertise in goal-oriented care was translated into a training package. While the development of this training package initially focused on functional integration of goal-oriented care through the use of tools, it became clear that a training on this concept requires teaching an attitude on goal-oriented care to all stakeholders in the care process. For sustainable implementation of goal-oriented care in primary care in Flanders, policymakers should therefore primarily focus on it’s normative integration.