Abstract
Background: Goal-oriented care (GOC) is a concept of care in which the patient’s personal goals are put first in decision making and organising the processes of care and support. Following the principles of GOC, care is organised based on the patient's values and what is important to the patient. GOC is an alternative to the dominating problem-oriented and disease oriented care model and of particular value for the increasing numbers of people with complex health and social needs. GOC and its readiness for implementation has been described in scientific literature, but research on GOC implementation in primary care organizations is limited. This study aims to capture the experiences of primary care organizations in implementing GOC in their context.
Approach: Primary care organizations received project funding to implement GOC in their context. The funding needed to be used to set up actions in the primary care community. The project leaders from these organisations had to participate in different peer learning activities. This way, a learning collaborative GOC was established in Belgium. In total 25 projects were selected, represented by different primary care organizations such as: patient organization, peer support group, multidisciplinary healthcare centres, networking organizations, home care services, health insurance company, advocacy organization, service for people with addiction, senior citizen organisation, social housing company… This study followed a qualitative description research design to capture the experiences of project leaders on implementing GOC in their context. Qualitative data were collected during one year through field notes (from the peer learning activities) a survey with open-ended questions and in-depth interviews and analysed using an inductive, thematic analysis.
Results: Seven themes supporting GOC implementation were identified. Project leaders from the primary care organizations experienced that related concepts can serve as a foundation for initiating GOC implementation. The implementation process is an iterative and reflective process, with resistance viewed as an integral part of the process, offering opportunities for reflection. Collaborating with partners, especially the active involvement of patients, was seen as a facilitator. Furthermore, having a clear vision for GOC is necessary. Projects invested in adapting tools and processes to align with GOC and provided relevant training.
Implications: The findings led to six recommendations that can guide the implementation form theory to practice of future GOC projects. Effective implementation extends beyond the development and adaptation of tools; it requires translating theoretical concepts into practical application and creating a shared vision on GOC.