Formulating SMART Objectives

The Implementation Team should link specific, measurable objectives to the goals identified in Action Plans. We suggest using SMART objectives, a set of goals characterized as being Specific, Measurable, Achievable, Realistic/Relevant, and Time-Bound. SMART objectives reflect the mileposts that will need to be achieved to implement an organizational change initiative according to agreed-on timeframes. SMART objectives should be based on the implementation strategies that the team has selected to reach each organizational change goal and will form the basis for monitoring progress based on the plan.

SMART objectives are used worldwide, especially for quality improvement and quality assurance in the healthcare field. Several tips from the Centers for Disease Control and Prevention can guide the Implementation Team in developing SMART objectives, which are described in Table 8.4.³^;⁴

Table 8.4

Tips to Create SMART Objectives³^;⁴

1. Specific

Formulate the objective in concrete, detailed, and well-defined terms so that expectations are clear.
Describe the objective using strong action verbs, such as “conduct,” “develop,” “build,” “plan,” or “execute.”
Avoid using verbs that may have vague meanings (e.g., “understand” or “know”) since the objective may then prove difficult to measure.
Use verbs that document action (e.g., at the end of the training session, participants will list three ways to create a more welcoming clinical environment for SGM patients).

2. Measurable

Focus the objective on “how much” change is expected, ideally in quantifiable terms.
Identify numbers and quantities for measurement and comparison purposes.
Determine the data sources needed to measure the expected change.

3. Achievable

Make sure that objectives can be feasibly implemented given various constraints, including resources, personnel, cost, and timeframe.

4. Realistic/Relevant

Relate the objective to the goal of the specific organizational change initiative.
Given clinic constraints, determine whether the objective is achievable.

5. Time-Phased

Include a timeframe indicating when the objective will be measured or a time by which the objective will be met.

The team can also use a version of Template 8.4 (Appendix A) to formulate and figure out if an objective can be considered SMART. This template has been adapted from the Centers for Disease Control and Prevention Community of Practice, which the team can access at the following website: https://www.cdc.gov/phcommunities/resourcekit/evaluate/smart_objectives.html.

TEMPLATE 8.4 Designing SMART Objectives³
Not-so-SMART objective 1: New frontline staff will be trained in SGM cultural competency practices.
Key Component	Objective
Specific – What is the specific implementation strategy?	Conduct new employee training to educate clinic personnel about SGM cultural competency practices that include the use of terminology and supportive language.
Measurable – How much change is expected?	The number of clinic personnel who take part in new employee orientation training each quarter features a 1.5-hour session on SGM cultural competency practices, including terminology and supportive language; the number of 1.5-hour sessions held each fiscal year.
Achievable – Can the implementation strategy be feasibly implemented?	Yes, given that the clinic sponsors a new employee training every three months and the access we have to an SGM cultural competency curriculum used in healthcare settings.
Realistic/Relevant – Given constraints, can the implementation strategy be completed?	Executive leadership supports the integration of a 1.5-hour SGM cultural competency component into the new employee training.
Time-Phased – What are the start and end dates?	January 14, June 5, August 15, and October 5
SMART objective 1: By December 31, 2023, the clinic will have conducted quarterly new employee training with all new frontline staff that has a 1.5-hour educational component about SGM cultural competency practices that includes terminology and the use of supportive language.