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The 4-h target: an example of destructive goal pursuit?
  1. Richard David Hardern
  1. Correspondence to Dr Richard David Hardern, Emergency Department, University Hospital of North Durham, North Road, Durham DH1 5TW, UK; richard.hardern{at}


Destructive goal pursuit (DGP) is the situation in which goal setting becomes dysfunctional, leading to impaired performance. This paper considers the 4-h target against the model of DGP and finds many similarities. It does not attempt to provide a critique of the model, nor does it seek to review all the effects of the 4-h target. The need for multiple goals, for all domains of quality to be addressed in these, and for a focus on effective team working and team learning are emphasised. Targets, in a way analogous to drugs or other ‘therapeutic’ interventions, have the potential to cause adverse effects as well as positive ones. A greater understanding will help ensure their overall impact is as beneficial as positive.

  • Goals
  • management
  • organisational objectives

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  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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