Goal setting and outcome measurement in a wheelchair service: A client-centred approach

Aims: There is increasing recognition of the need for a client-centred approach to health-care provision, which takes into account how people live with their health condition in all domains of life. This study aimed to explore assessment practices for clients requiring standard wheelchairs in one wheelchair service in the UK, and develop a framework for setting client-centred goals and measuring outcomes that uses this approach. Methods: An action research approach was adopted within the normal parameters of the wheelchair service. A brief review of relevant literature was undertaken, and an assessment and prescription form incorporating client-centred goals was then developed and implemented. Outcomes were collected from clients using a telephone questionnaire. A focus group was used to elicit the views, beliefs and working practices of therapists. Findings: The data gave an insight into the type of functional mobility goals that clients set. Goal setting was an unfamiliar concept for most clients, and therapists stated that they needed to guide them through the process. Formulating goals at the start of the assessment process helped both therapist and client focus on the outcomes the client wanted to achieve. Conclusions: This project demonstrates how a conceptual change to services can be achieved. The process for setting client-centred goals and measuring outcomes was quick to implement and has orked effectively in practice; crucially by ensuring clients' own goals are achieved.