To identify facilitators and barriers for physiotherapists in documenting the patient´s treatment goal in electronic health records at the hospital.
To identify influencing factors, a survey and focus group discussions were conducted in a university hospital. The utilized survey, informed by a systematic review of facilitators and barriers for shared decision-making and the theoretical domains framework (TDF), included 25 statements on potential influencing factors. The focus group discussions addressed two identified barriers from the survey, discussed the process of setting treatment goals, and brainstormed existing influencing factors for documenting physiotherapeutic goals.
Eight physiotherapists participated in the survey as well as in the focus group discussions, respectively.
In the survey, physiotherapists conflicted on most statements but agreed that the patient goal 1) was set with the patient, 2) influences the therapeutic interventions, and 3) can motivate patients and therapists. The participants disagreed that 1) another goal-setting tool was needed, 2) the goal is influential beyond the hospital stay, and 3) the goal is of interest to other professions.
In the focus group discussions, four main themes evolved: 1) “Goal”, 2) “Physiotherapeutic Self-Conception”, 3) “Interprofessionality”, and 4) “Hospital Setting”. Contradicting to the survey findings, concerns were raised regarding the "Goal" component, specifically highlighting the insufficient space and suboptimal placement of the tool within the documentation system. Within the context of "Physiotherapeutic Self-Conception", it was noted that goals are often conceptualized mentally and not routinely documented. Furthermore, as in the survey, it was perceived that interprofessional team members exhibited a lack of interest in documentation and goal setting, leading to physiotherapists' deprioritization. Additionally, it was acknowledged that in the “Hospital Setting”, particularly in the intensive care unit, joint goal setting was infeasible for some patients.
We identified factors influencing the goal-setting and documentation process of physiotherapists working at a university hospital. These factors relate to the available goal-setting tool, the professionals, the organization, and the external context. They should be considered and addressed in interventions to improve physiotherapeutic goals-setting in the hospital setting.
To allow a broader generalization of the findings, studies in different hospital settings are required. However, at the study site´s hospital, to increase the utilization of the physiotherapeutic goal-setting tool, its design and localization need to be discussed and adjusted with the physiotherapists. In a training course, we will address the physiotherapist's self-conception relating to the goal-setting process. Finally, interventions like policies or courses to improve interprofessional communication and collaboration inside the hospital organization regarding goal-setting are wanted.
Facilitators and Barriers
Mixed methods
