出版社：Utrecht University, Maastricht University, Groningen University
摘要：Background : The current logic of the care system divides the person’s health issues into a set of problems to be solved separately in parallel by respective specialists. However, such specialization predisposes the system to behave as if patients are anonymous representatives of a biological condition. This systematic depersonalization is experienced as a deeply offensive, as well as ineffective. The only person who can legitimately make overarching goals which allow all professionals to work towards a common goal across organization and specialization is the person him/herself. However, the development and recording of personal goals have little support in current care-organization and e-health systems. There is little attention on how to systematically identify the patients’ individual needs, values, preferences, and care goals, and how to apply them to treatment decisions and care evaluation. Aims and objectives : We first discuss what a systematic identification of patient goals might look like. We then discuss barriers and enablers in relation to the integration of personal goals of patients with LTC into 1) their care plans and 2) possible technologies to support the goal achievement. We apply a service design thinking approach, using service design methods including healthcare journey modelling and participatory scenario design, which can facilitate the discussion and help the participants to vocalize/articulate their thoughts and beliefs. Format : We first present an example of a successful application of goal planning among community living older adults in the Netherlands (poster ID 264, 8-10 minutes). We then have a series of short presentations about a typology of personal goals, patient empowerment, service design thinking, and the procedure of the group work (10-12 minutes). During the group work (total 40 minutes), we show a patient journey (clinical pathway) of a citizen with COPD and encourage the participants to discuss 1) barriers and enablers of integrating personal goals into this journey 2) possible technology support for the goal achievement (30 minutes). After the group work, the participants gather again and report the summary of the discussion (10 minutes). Target audience : Healthcare professionals, health service managers, administrators, policymakers, and researchers. Learnings/Take away : We expect that the participants gain new insights into the systematic identification of personal goals of people with LTC, as well as the existing barriers and enablers for integrating personal goals in their care plan. Participants will also have innovative ideas about how the goal setting can be facilitated and supported by technology assistance. The obtained ideas can be shared and used for the participants’ own projects and the participants can also take the service design thinking approach demonstrated in the workshop home to involve their local stakeholders in the further patient-centred design of care plans in digital solutions. For example, the ideas can be further discussed with individuals/citizens with LTC to co-create mutual value of digitalized individualized care plans for both caregivers and citizens with LTC.
关键词：long term conditions ; personal goals ; people centered ; service design
