Goal setting in the community

How does goal setting in the community differ from that in hospital?

Hospital

Shorter timescales are set for each goal

Patients are expected to make progress more quickly at this stage of their recovery therefore the timeframes are appropriately short.

Goals are more focused on impairment and activity

The early focus of rehabilitation is often on recovery of impairments.

The environment is very structured and safe

Hospital provides a controlled environment with adequate space, equipment and staff.

MDT available all the time

MDT in the stroke unit work within the unit and are more accessible.

Patient expected to lead the process

                   Patients are expected to be involved in discussions around goal setting and the                                   identification of meaningful goals for the person, albeit with a significant level of                              support and some direction from professionals.  The goals identified here may relate                       more to the acute stages in stroke management and preparation for safe discharge.

Community

Longer timescales are set for each goal

Patients are expected to make slower progress at this stage of their recovery therefore the timeframes are appropriately longer.

Goals are more focused on activity and participation

As the patient’s focus alters from recovery to engaging in normal activities the goals move from impairment to much wider aspects.

The environment is more challenging and less safe

Patients’ homes offer less space, present potentially greater hazards and less supervision is available.

The MDT composition may involve a variety of agencies

Patient may have health and social care input with varied levels of understanding and expertise in goal setting and therefore may be less able to provide support.

Communication with the team is more difficult

Diverse MDT group may be involved from varied sources which can make communication more complex and time consuming.

Patient expected to lead the process

         Patients are expected to have greater understanding of goals that are meaningful to them personally and autonomy over goal setting and action planning with different or less direct involvement from professionals. The goals identified here may relate more broadly to stroke survivors’                    re-engagement in their lives after a stroke.