Goal finding concepts
At the July 2021 meeting following a request for input, the Nursing CRG discussed goal concepts.
The Nutrition Group had had a finding concept added: 1162727003 |Goal discontinued (finding)|. Since this concept together with other current goal finding concepts 390800000 |Goal achievement finding (finding)| and subtypes was relevant to other domains including nursing, the Nursing group was asked to comment on this type of content.
See: https://dailybuild.ihtsdotools.org/?perspective=full&conceptId1=390800000&edition=MAIN&release=&languages=en
List of those specific concepts below:
|Goal achievement finding (finding)|
|Care plan goal achievement status unknown (finding)|
|Goal achieved (finding)|
|Goal not achieved (finding)|
|Goal discontinued (finding)|
|Goal not attainable (finding)|
|No progress toward goal (finding)|
|Incongruent personal goals (finding)|
|Some digression away from goal (finding)|
|Some progress toward goal (finding)|
Blog post link:https://snomed.atlassian.net/wiki/display/Nursing/2021/07/07/Nursing+Clinical+Reference+Group+-+Meeting+Reminder
The discussion had by the nursing CRG was recorded:https://snomed.atlassian.net/wiki/display/Nursing/2021-07-13+-+Nursing+CRG+Meeting
Comments
Response from the Nutrition Group following the above:
In regards to the question asked about use of "and/or" in concepts like "Food and/or nutritional goal not attainable (finding)," Sometimes the goal pertains to food, sometimes to nutrition (nutrients), and sometimes it is a combination of the two. It is difficult to tease them apart in each situation as it depends on various factors such as the way nutrients react in food or the way they are absorbed, for example. Having three separate concepts (food, nutrition, food and nutrition) would be difficult to manage so they choose to go with the "and/or" approach.
In regards to the question about other potential content like 'elimination goal not achieved', 'mobility not achieved' and 'pain not achieved', they don't have elimination content they are sending forth to be added to SNOMED. They have findings related to elimination but they are existing concepts; no new concepts will be added. They don't deal with pain goals. Mobility information is not really in their domain, but the needed information is already included via different phrasing, e.g., are they able to feed themselves.
The implementations of care planning content in the UK would be unlikely to support widespread expansion of pre-coordinated goal achievement findings as this will actually make multidisciplinary person centric care planning more challenging to implement rather than less.
Nursing CRG summary points:
Goals also used by other professions such as physios. Wording varies but as long as FSN is clear synonyms can be added as needed. Suggested specific group text definitions not be used as these then need to be validated with each profession.
There were no comments on the Goal discontinued (finding) concept.
The new concept Food and/or nutritional goal not attainable (finding) was questioned given the and/or.
Questions were asked about other potential content like 'elimination goal not achieved', 'mobility not achieved' and 'pain not achieved'. The potential for multiple combinations and other ways to record was raised briefly.