OBJECTIVES: Goal Attainment Scaling (GAS) is a patient-centric outcome measure that quantifies the impact of interventions on personalized goals. GAS interviewers (clinicians/academics) use GAS and incorporate input from patients/caregivers on clinically meaningful goals and their attainment. We explored GAS usage, GAS challenges and effects of the SARS-CoV-2 pandemic on GAS practice.

METHODS: A semi-structured guide was used to interview eleven GAS interviewers from Canada, US, UK and Australia. Recorded interviews were transcribed, themes were identified, and data were coded in NVivo 12.

RESULTS: Four interviewers had used GAS for 20+ years, 5/11 were introduced to GAS through an article/conference and 7/11 were currently using GAS. Six interviewers used a 5-point scale (-2, -1, 0, +1, 2) with varying baseline levels. An advantage of GAS was that patients/caregivers set personally meaningful goals related to daily life. Results were also readily interpretable and actionable. For example, a decline in GAS scores indicated a need for higher levels of patient care. Seven interviewers commented that GAS was reliable and helped identify issues meaningful and relevant to patients/caregivers. Use of a goal inventory or prompting focused GAS interviews (10/11) to shorten interview time (11/11). Good interviewing skills were found essential (8/11) to setting quality goals. Most interviewers (8/11) were open to new processes for conducting GAS, including innovations to simplify interviewing. Several interviewers thought that those not using GAS were resistant to change or did not realize its value (4/11). Interestingly, the SARS-CoV-2 pandemic had several positive impacts on GAS use, as virtual appointments eliminated travel for patients and/or interviewers.

CONCLUSIONS: GAS interviewers stressed the importance of interviewing skills, setting goals that were meaningful to patients/caregivers, and using goal inventories or prompts. Innovative GAS methods would be welcomed if they were time-saving and improved GAS usage.