Writing goals can be challenging, especially in the ever changing world of reimbursement. Many of us are familiar with writing SMART (Specific, Measurable, Attainable, Relevant, Timely) goals, but can we do better? Goals should not just be a box we check off when completing documentation requirements. We must remember as providers that documentation serves a valuable purpose, no matter how tedious the process may be. Goal writing is one of the most important elements of documentation. So how can you make sure you are writing goals that serve your clients and meet reimbursement standards? Consider the following 4 tips:
- Dead Man Test – The name of this is morbid, I know. It does serve a valuable purpose when goal writing though. When writing a goal, ask yourself “can a dead man do this?”. If the answer is yes, you need to consider a new way of writing the goal. Goals that do not pass the Dead Man Test often include words that are passive or describe what is not happening (The client will not exhibit challenging behaviors…). Goals that pass the test include active behavior words (The client will utilize materials and engage with peers…)
- Stranger Test – This test does what the title says. When you write a goal, could a stranger understand it? Think about the jargon you use and the words that may convey different meanings to different readers. For example, if you write a goal about a client exhibiting “inappropriate social behavior” that may mean physical aggression to one person and verbal aggression to another. Give specific examples of the behavior you are measuring and try to avoid generalizations.
- So What? – This was a new one for me, but so needed! I read a lot of documentation in my role as a consultant and this is an issue for so many providers. This test asks the question “if the client were to attain this goal, would it make a meaningful difference in his/her function?” That being said, if you are writing goals that are solely based on items missed within a standardized assessment, my guess would be that it often would not pass this test. Function should be the first thing you think about when developing a goal. If a goal is functional it will show meaningful results for the client and more likely to meet medical necessity policies for reimbursement purposes.
- Make the goals SMARTER! – Using the acronym mentioned at the beginning of this article and adding two more elements. The E stands for Evaluate. This is key for any goal we develop. We should Measure the data and Evaluate the effectiveness of how the goal was written. The R in the initial use of the acronym is often used to mean both Relevant and Reasonable; however, with this acronym it separates that out so that both issues can be addressed.Put these strategies into action and you will see that your goals not only meet the needs of your client and the reimbursement agencies, but they work better for you too!