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Setting performance targets and managing to achieve them is fundamental to business success. Targets provide explicit direction to the organization and motivate management to strive for ever higher levels of performance. Jack Welch has described the setting of stretch targets as one of General Electric's three main operating principles, one that “inspires people and captures their imaginations” creating an atmosphere that asks of everyone. “How good can you be?”

ObjectiveTo identify children and young people’s preferences for effective healthcare communication.DesignA systematic review of qualitative studies was conducted to identify evidence from children and young people on effective healthcare communication. Electronic databases and reference lists of relevant articles were searched to July 2020.ResultsA total of 13 studies were included. Five major themes were identified: medical information (timing, amount, coordination and futures), person not patient (creating relationships, time, nurse involvement, sensitivity), type of communication (creative and interactive, behavioural, talking and listening, written communication), consultations (first impressions, with and without parents, actively promoting involvement, open and honest, age appropriate) and communication with parents (using parental knowledge, support).ConclusionsResearch in this area remains sparse and consistent implementation is debateable. Children and young people articulate a preference for two-way healthcare communication. General principles for effective communication are identified as well as the need to avoid making assumptions and to tailor approaches to individuals. Establishing and maintaining relationships is essential and requires time and resources. Parents and carers have a positive role in healthcare communication which needs to be balanced with the needs and rights of children. All these factors also apply to children with communication difficulties or from marginalised groups, but additional extra support may be required.PROSPERO registration numberCRD42019145539.

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