Personalized Careplan
It is the output of a collaborative “care planning” process, which aims to maximize the patient’s capacity to self-care. There is only one per patient, and it is personalized and specific to that patient.
- It shows the overall plan for the care of that patient – all specialties and all support needs.
- It is not just about clinical interventions but also covers both clinical and personal goals.
- It should be structured around a minimum core set of information:
1. “Problems” (e.g. Diabetes)
2. “Needs” (e.g. Blood Glucose Management)
3. “Goals” (e.g. Blood Glucose Normal) – these must be meaningful to the patient.
4. “Activities” (e.g. Review Medication, Refer to Dietician)
- It should be created and updated in consultation with the patient.
- The patient should have access to it and be able to understand it.
I hope you like it!
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