All successful programmes share goal-setting as a standard practice, and many write their goal statements to satisfy the S.M.A.R.T. criteria. To be SMART, objective statements should be constructed to specify four components: Outcome, Indicator, Target-level and Timeframe (O.I.T.T.). This study reviewed the goal framework of published objective statements to determine the extent to which they are SMART. The statements of 17 published examples of SMART objectives found in literature of mainly four major health organisations: CDC, WHO, NHS and Save the Children, were structurally analysed to measure the completeness of their goal framework according to the OITT components. Only four examples are outcome objectives. 13 (76%) are process or task oriented. The structure of two thirds of the statements shows the similar objective-writing templates used within CDC. All objective statements have an incomplete set of OITT components. The commonest framework has 3 components of indicator, target and timeframe (75% completeness) in 12 statements. Almost all statements specify a timeframe; three-quarter of them mention a target and three-fifth an indicator, but less than 1 in 5 state an outcome. Thus, none of the objective statement is really SMART, and goal-setters are significantly less likely to specify an outcome, than indicator, target or timeframe in their objectives. A high prevalence of non-SMART objectives with low potential for goal attainment in healthcare projects is proposed.

Goal-setting is fundamental to organisational management, yet not every manager knows how to do it well. A narrative literature review was done to explore current knowledge of definitions and classifications of goals, and principles of goal-setting in the healthcare sector. Online databases generated 65 relevant articles. Additional literature sources were snowballed from referenced articles, and textbooks. Most academic authors define ‘goal’ synonymously as ‘aim’ or ‘objective’, but there is evidence of hermeneutical confusion in general literature. Goal classifications are diverse, differing according to their contextual, structural, functional, and temporal characteristics. Many authors agree that goal-setting is problem-based, change-oriented, and can effectively motivate attainment if the goal statement is formulated with a specific and challenging or SMART framework. However, recent authors report varying definitions for SMART, and evidence of past studies that empirically examined the nature and efficacy of frameworks currently used for formulating goal statements for health programmes are lacking.

Goal, aim, objective and target are conceptually different. New frameworks for writing complete goal statements are proposed, including I.T. and O.I.T.T. frameworks for aim and objective respectively.

Background/aims Goal setting is a fundamental practice in the effective management of healthcare services worldwide. This study investigated the extent to which leprosy goal formulation in Nigeria is logical and SMART. Methods Document review of baseline problems, goal statements and goal attainments for 2016 in six leprosy projects using a customised logical framework matrix. Results A total of 15 main problems, 6 aims, 19 objectives and 42 indicators were found. The goals were problem-based and logically linked, with a pattern of a single aim per project, multiple objectives per aim, and multiple indicators per objective. Goal statements specified only impact in 5 out of 6 aims, and only outcome and terminal timeframe in 17 out of 19 (89.5%) objectives. Only one objective stated all four SMART components of outcome, indicator, target and timeframe. While three (7.1%) indicators and two (10.5%) objectives were measurable, no target was attainable. Conclusions Goal-setting frameworks for leprosy projects should be problem based and logical according to best practice. That most leprosy objectives were not completely SMART is similar to the reported structure of objectives published by other health organisations globally.

A survey was carried out on healthcare professionals in Nigeria on point of care testing in critical care. The respondents considered the glucose test as the most essential critical test followed by Full Blood Count (FBC), and then electrolytes, urea and creatinine. Blood gases ranked quite low with only 62% of the healthcare professionals considering them as a critical blood test. This was confirmed as it was found that only 31.6% of the respondents had blood gases devices in their institutions. Abbott's i-STAT was the most common POCT device used for blood gas estimation by 45% of the respondents, followed by Instrumentation Laboratories, 3500 and 4000 series (9.8%) and then by Roche's Cobas B221 (9%). From the features of blood gas devices which included price of analyser, price of cartridge, analysis time, portability, range of tests, power supply and volume of blood used, the price of analyser, was the product feature that respondents considered as most important. About one third of respondents ranked analysis time or range of tests possible as a priority specification, while about one quarter prioritised portability, price of cartridge or volume of blood needed. Power supply was the lowest ranking feature. dialysis and intensive care units, the average turn-around time