TY - JOUR
AU - R. Haverals
AU - S. Anthierens
AU - Steele Gray
AU - P. Pype
AU - K. Van den Broeck
AU - P. Boeckxstaens
A1 - 
AB - BACKGROUND: As healthcare systems transition toward person-centred integrated care (PC-IC), goal-oriented care (GOC) has gained prominence as a conceptual approach to aligning care with what matters most to patients. However, there is limited empirical insight of how GOC is enacted in daily practice and what competencies this requires from providers. This study explores how primary care providers enact GOC in daily practice to inform future training and competency development. METHODS: A focused, team-based ethnographic approach was used, combining non-participant observations with short reflective interviews. Primary care providers were purposively sampled from a cohort who completed interprofessional GOC training, ensuring disciplinary diversity. Data were analysed using thematic analysis to identify behaviours and competencies underpinning GOC in practice. RESULTS: Providing GOC requires competencies beyond knowledge or task-specific skills, and is enacted through contextual, relational, and reflective competencies. Providers showed contextual awareness by linking care actions to patients' lived experiences and personal goals. They built relational trust through open, authentic, and non-hierarchical communication to co-create care decisions with patients. Reflective competence was shown when providers reassessed care decisions in light of patient goals, assumptions, and team input. CONCLUSIONS: These findings highlight the importance of strengthening reflective competencies in training of primary care providers. In practice, this entails supporting providers to reflect on their professional responsibilities, alongside those of the other disciplines they work with in health and social care; and critically engage with assumptions. This reflective capacity is key to embedding GOC in daily practice and aligning care with what truly matters to patients.
AD - Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium. Reini.Haverals@ugent.be.; Department of Family Medicine and Population Health, Faculty of Medicine and Health sciences, University of Antwerp, Antwerp, Belgium.; Science of Care Institute, Lunenfeld-Tanenbaum Research Institute, Sinai Health Toronto, Ontario, Canada.; Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada.; Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
AN - 41491798
BT - BMC Prim Care
C5 - Education & Workforce; Healthcare Disparities
CP - 1
DA - Jan 6
DO - 10.1186/s12875-025-03165-6
DP - NLM
ET - 20260106
IS - 1
JF - BMC Prim Care
LA - eng
N2 - BACKGROUND: As healthcare systems transition toward person-centred integrated care (PC-IC), goal-oriented care (GOC) has gained prominence as a conceptual approach to aligning care with what matters most to patients. However, there is limited empirical insight of how GOC is enacted in daily practice and what competencies this requires from providers. This study explores how primary care providers enact GOC in daily practice to inform future training and competency development. METHODS: A focused, team-based ethnographic approach was used, combining non-participant observations with short reflective interviews. Primary care providers were purposively sampled from a cohort who completed interprofessional GOC training, ensuring disciplinary diversity. Data were analysed using thematic analysis to identify behaviours and competencies underpinning GOC in practice. RESULTS: Providing GOC requires competencies beyond knowledge or task-specific skills, and is enacted through contextual, relational, and reflective competencies. Providers showed contextual awareness by linking care actions to patients' lived experiences and personal goals. They built relational trust through open, authentic, and non-hierarchical communication to co-create care decisions with patients. Reflective competence was shown when providers reassessed care decisions in light of patient goals, assumptions, and team input. CONCLUSIONS: These findings highlight the importance of strengthening reflective competencies in training of primary care providers. In practice, this entails supporting providers to reflect on their professional responsibilities, alongside those of the other disciplines they work with in health and social care; and critically engage with assumptions. This reflective capacity is key to embedding GOC in daily practice and aligning care with what truly matters to patients.
PY - 2026
SN - 2731-4553
SP - 47
ST - Putting "what matters to you?" into practice: a focused team-based ethnographic study on goal-oriented care
T1 - Putting "what matters to you?" into practice: a focused team-based ethnographic study on goal-oriented care
T2 - BMC Prim Care
TI - Putting "what matters to you?" into practice: a focused team-based ethnographic study on goal-oriented care
U1 - Education & Workforce; Healthcare Disparities
U3 - 10.1186/s12875-025-03165-6
VL - 27
VO - 2731-4553
Y1 - 2026
ER -