Expert Consensus-Based Development of a Multidisciplinary Weekly Goal-Setting Framework for Subacute Stroke Rehabilitation.
Kang Kyoungyee K, Lee Junesung J, Lee Ji Won JW, Baek Chang-Yoon CY et al.
Multidisciplinary rehabilitation and structured goal setting are strongly recommended in subacute stroke care. However, in clinical practice, regular multidisciplinary goal-setting approaches have not been consistently implemented because of time and logistical constraints. To develop a structured multidisciplinary goal-setting framework for subacute stroke rehabilitation through a single-center expert consensus process. A multidisciplinary inpatient rehabilitation framework was developed through a targeted literature review and structured expert consensus meetings. A 12-member multidisciplinary panel held 10 face-to-face meetings at 2-week intervals to define the rehabilitation domains, workflow structure, and implementation strategy. Components were adopted through iterative multidisciplinary discussion until agreement was reached. No formal voting was conducted, and no quantitative consensus threshold was prespecified. The final framework comprised three phases: admission, weekly inpatient cycles, and discharge. It integrated domain-specific assessments and problem lists, with structured inpatient and weekly goals based on the specific, measurable, achievable, relevant, and timed criteria. In the framework, goal attainment is evaluated using goal attainment scaling, supported by weekly progress documentation. An electronic medical record-based asynchronous communication model was proposed for future implementation to support multidisciplinary coordination. This framework was designed to support structured weekly multidisciplinary goal setting after subacute stroke. Its feasibility, usability, and effects on clinical outcomes have not been evaluated, and prospective multicenter validation is required.