Care planning is a “whole of care” dynamic process involving needs identification and analysis, development of goals and an action plan, referral, feedback, care coordination and monitoring, review, reassessment and exiting. These are all required to achieve quality outcomes for the consumers of a service.
While terminology and language around care planning may vary between services providers, the basic “care” planning process undertaken by different services and organisations tends to be fairly consistent.
Complexity arises however, if two or more provider are involved in the shared care of a consumer and this complexity increases the more practitioners and organisations that become involved.
This complexity leads to a greater need for effective monitoring, communication and coordination. Therefore, shared understandings and agreements on the processes and systems of care between providers are essential prerequisites for successful shared care planning.
Primary Care Partnerships across Victoria have extensive experience in supporting partner organisations develop and implement effective shared care practices, procedures and policies.