Skip to main content
Canadian Family Physician logoLink to Canadian Family Physician
. 1999 Apr;45:954–960.

Goal attainment scaling in a geriatric day hospital. Team and program benefits.

D J Evans, S Oakey, S Almdahl, B Davoren
PMCID: PMC2328321  PMID: 10216794

Abstract

PROBLEM BEING ADDRESSED: The Geriatric Day Program (GDP) of the Capital Health Region in Victoria, BC, is concerned with effective team processes, accountability for health service outcomes, and improving the quality of programs. The GDP identified a need to improve its interdisciplinary processes and generate useful patient outcome data. OBJECTIVE OF PROGRAM: To determine whether Goal Attainment Scaling (GAS) could be introduced to facilitate interdisciplinary processes and to generate useful health outcome data. MAIN COMPONENTS OF PROGRAM: The GAS procedures were incorporated into clinical routines based on published guidelines. The authors determined GAS outcome scores for patients who completed the program and developed outcome scores for specific geriatric problem areas requiring intervention. Outcome scores were made available to the clinical care team and to program managers for continuous quality improvement purposes. CONCLUSIONS: The GAS process was successfully implemented and was acceptable to clinicians and managers at the GDP. Team processes were thought to be improved by focusing on patient goals in a structured way. The GAS provided data on both patient outcomes and outcomes of interventions in specific problem areas. Accountability for patient care increased. Goal Attainment Scaling provided indicators of care for which clinicians could develop program quality improvements.

Full text

PDF
954

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Engelhardt J. B., Toseland R. W., O'Donnell J. C., Richie J. T., Jue D., Banks S. The effectiveness and efficiency of outpatient geriatric evaluation and management. J Am Geriatr Soc. 1996 Jul;44(7):847–856. doi: 10.1111/j.1532-5415.1996.tb03747.x. [DOI] [PubMed] [Google Scholar]
  2. Fox R. A., Clarfield A. M., Hogan D. B. Competencies required for the practice of geriatric medicine as a consultant physician. CMAJ. 1989 Nov 15;141(10):1045–1048. [PMC free article] [PubMed] [Google Scholar]
  3. Heavlin W. D., Lee-Merrow S. W., Lewis V. M. The psychometric foundations of goal attainment scaling. Community Ment Health J. 1982 Fall;18(3):230–241. doi: 10.1007/BF00754339. [DOI] [PubMed] [Google Scholar]
  4. Kiresuk T. J., Lund S. H., Larsen N. E. Measurement of goal attainment in clinical and health care programs. Drug Intell Clin Pharm. 1982 Feb;16(2):145–153. doi: 10.1177/106002808201600210. [DOI] [PubMed] [Google Scholar]
  5. Malec J. F., Smigielski J. S., DePompolo R. W. Goal attainment scaling and outcome measurement in postacute brain injury rehabilitation. Arch Phys Med Rehabil. 1991 Feb;72(2):138–143. [PubMed] [Google Scholar]
  6. Melin A. L., Wieland D., Harker J. O., Bygren L. O. Health outcomes of post-hospital in-home team care: secondary analysis of a Swedish trial. J Am Geriatr Soc. 1995 Mar;43(3):301–307. doi: 10.1111/j.1532-5415.1995.tb07343.x. [DOI] [PubMed] [Google Scholar]
  7. Miller D. K., Coe R. M., Romeis J. C., Morley J. E. Improving quality of geriatric health care in four delivery sites: suggestions from practitioners and experts. J Am Geriatr Soc. 1995 Jan;43(1):60–65. doi: 10.1111/j.1532-5415.1995.tb06244.x. [DOI] [PubMed] [Google Scholar]
  8. Powell C., Nixon M. Caring for patients in geriatric day hospitals: guidelines on the relationship between primary care physicians and specialist/consultants. Can Fam Physician. 1996 Jan;42:110-5, 117. [PMC free article] [PubMed] [Google Scholar]
  9. Reuben D. B., Fishman L. K., McNabney M., Wolde-Tsadik G. Looking inside the black box of comprehensive geriatric assessment: a classification system for problems, recommendations, and implementation strategies. J Am Geriatr Soc. 1996 Jul;44(7):835–838. doi: 10.1111/j.1532-5415.1996.tb03744.x. [DOI] [PubMed] [Google Scholar]
  10. Rockwood K., Stolee P., Fox R. A. Use of goal attainment scaling in measuring clinically important change in the frail elderly. J Clin Epidemiol. 1993 Oct;46(10):1113–1118. doi: 10.1016/0895-4356(93)90110-m. [DOI] [PubMed] [Google Scholar]
  11. Rockwood K., Stolee P., Howard K., Mallery L. Use of Goal Attainment Scaling to measure treatment effects in an anti-dementia drug trial. Neuroepidemiology. 1996;15(6):330–338. doi: 10.1159/000109923. [DOI] [PubMed] [Google Scholar]
  12. Rubenstein L. V., Calkins D. R., Greenfield S., Jette A. M., Meenan R. F., Nevins M. A., Rubenstein L. Z., Wasson J. H., Williams M. E. Health status assessment for elderly patients. Report of the Society of General Internal Medicine Task Force on Health Assessment. J Am Geriatr Soc. 1989 Jun;37(6):562–569. doi: 10.1111/j.1532-5415.1989.tb05690.x. [DOI] [PubMed] [Google Scholar]
  13. Rubenstein L. Z., Josephson K. R., Wieland G. D., English P. A., Sayre J. A., Kane R. L. Effectiveness of a geriatric evaluation unit. A randomized clinical trial. N Engl J Med. 1984 Dec 27;311(26):1664–1670. doi: 10.1056/NEJM198412273112604. [DOI] [PubMed] [Google Scholar]
  14. Rubenstein L. Z., Stuck A. E., Siu A. L., Wieland D. Impacts of geriatric evaluation and management programs on defined outcomes: overview of the evidence. J Am Geriatr Soc. 1991 Sep;39(9 Pt 2):8S–18S. doi: 10.1111/j.1532-5415.1991.tb05927.x. [DOI] [PubMed] [Google Scholar]
  15. Stolee P., Rockwood K., Fox R. A., Streiner D. L. The use of goal attainment scaling in a geriatric care setting. J Am Geriatr Soc. 1992 Jun;40(6):574–578. doi: 10.1111/j.1532-5415.1992.tb02105.x. [DOI] [PubMed] [Google Scholar]
  16. Stuck A. E., Siu A. L., Wieland G. D., Adams J., Rubenstein L. Z. Comprehensive geriatric assessment: a meta-analysis of controlled trials. Lancet. 1993 Oct 23;342(8878):1032–1036. doi: 10.1016/0140-6736(93)92884-v. [DOI] [PubMed] [Google Scholar]

Articles from Canadian Family Physician are provided here courtesy of College of Family Physicians of Canada

RESOURCES