PT Classroom - The Importance of Writing Patient Centered Functional Physical Therapy Goals ׀ by Chai Rasavong, MPT, MBA


As our healthcare system continues to evolve, it will be even more important for us to not only maintain quality of care for our patients but to ensure reimbursement for our services as well. One step that we can take to maximize outcomes for both parties is to facilitate an increase in patient participation with physical therapy goal setting. “Patients are likely to make the greatest gains when therapy and the related goals focus on activities that are meaningful to them and will make a difference in their lives (1)”. This can translate to an enhancement in patient compliance which can lead to better patient outcomes.

According to Guide to Physical Therapist Practice (2), physical therapists are expected to involve the patient (and family members and significant others, if appropriate) when establishing goals and outcomes. The goals and outcomes should be stated in measurable terms. They should be related to impairments, functional limitations, and disabilities and changes in health, wellness, and fitness needs identified in the examination. In addition, health care policy, reimbursement practices, and the standards of accrediting bodies also recognize the value of working toward achieving abilities that are meaningful to patients and increasingly require the goals of physical therapy and other professional services to be patient-centered and functional (1).

As physical therapists, we may think that we have developed a collaborative relationship with our patients when we are developing patient centered goals, but are we doing enough? Baker et al (3) conducted a study to determine whether physical therapists seek to involve patients in goal setting and, if so, what methods they use. Their study involved twenty-two physical therapists who had the initial evaluations of 73 elderly patients audiotaped. The audiotaped examinations were then scored using the Participation Method Assessment Instrument to determine the frequency of attempts made by physical therapists to involve patients in goal setting. Their study found that in most cases, the physical therapists did seek to involve their patients in goal setting, but at levels that are less than the potential that may exist.

So what steps can we take to help improve our goal writing skills? Randall et al (1) found the following steps useful to identifying goals with patients: 1) determine the patient’s desired outcome of therapy, 2) develop an understanding of the patient’s self-care, work, and leisure activities and the environments in which these activities occur, and 3) establish goals with the patient that relate to the desired outcomes. If patients can’t express their needs, family members or significant others may do so for them.

Once we have determined the general outcomes desired by the patients we need to translate these desired outcomes into patient centered goals which are time bound, measurable and functional (1, 2, 3, 4). By writing patient centered goals this will help us to better conform to health policy, to be reimbursed for interventions, to assist in meeting the expectations of accreditation process and legislation, and ultimately to meet the unique needs of our patients (1).

Last revised: November 11, 2009
by Chai Rasavong, MPT, MBA


1. Randall K & McEwen I. Writing Patient-Centered Functional Goals. Physical Therapy. 2000;80:1197-1203.
2. Guide to Physical Therapist Practice. Physical Therapy. 2001;81:9-744.
3. Baker S et al. Patient Participation in Physical Therapy Goal Setting. Physical Therapy. 2001;81:1118-1126.
4. Kettenbach G. (1990). Writing SOAP Notes - Second Edition. Philadelphia, PA:F.A. Davis Company.

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