Shared Decision-Making Care Plan

Key objectives

To provide a digital care plan for patients to document decisions made about their treatment and their oncology diagnosis.


Outcome measures

Equip every patient with the tools to document and record their decisions and share with their healthcare professionals/family and carers.


Current Baselines

Documenting patient's goals was very disjointed and patients didn't always get cope or they lost it. Made reviewing the goals a useless exercise. Patients were left feeling disempowered and not in control of their rehab.


Workflow


  1. Patient: Claim their PKB record

  2. Patient: Views appointment in their PKB record

  3. Patient: Attends virtual or face to face appointment

  4. Team: Views patients PKB record

  5. Team: Adds care plan to the patient's record

  6. Patient: Uses care plan to record and review goals

  7. Team: Has the ability to view patients goals and review in appointments along with other data in the record

Joint Neuro Clinical Goal Planning Meeting care plan template

Example care plan template code for Joint Neuro Clinical Goal Planning Meeting Care Plan HTML

<div class="form-inline">

<style media="screen">

a {word-wrap: break-word;}

.form-group {width: 100%; !important}

.cp_label {font-size: 18px;font-weight: 900;}

.cp_whiteBox {background-color:#ffffff; padding:15px; margin-bottom:10px; margin-top:10px; -moz-border-radius: 10px; -webkit-border-radius: 10px; -khtml-border-radius: 10px; border-radius: 10px;}

</style>

<div class="cp_whiteBox">

<h2>JOINT NEURO CLINIC GOAL PLANNING MEETING</h2>

<div class="row">

<div class="col-sm-6">

<label class="cp_label" for="cp_meetingNumber">No of meeting</label>

</div>

<div class="col-sm-6" style="margin-top: 15px;">

<input type="text" name="cp_meetingNumber" id="cp_meetingNumber" class="form-control" style="width: 100%;"></input>

</div>

</div>

<div class="row">

<div class="col-sm-6">

<label class="cp_label" for="cp_meetingDate">Date of Meeting</label>

</div>

<div class="col-sm-6" style="margin-top: 15px;">

<input type="date" name="cp_meetingDate" id="cp_meetingDate" class="form-control" placeholder="dd/mm/yyyy"></input>

</div>

</div>

<div class="row">

<div class="col-sm-6">

<label class="cp_label" for="">Stage of treatment:</label>

</div>

<div class="col-sm-6" style="margin-top: 15px;">

<input type="text" name="REPLACE" id="REPLACE" class="form-control" style="width: 100%;"></input>

</div>

</div>

<div class="row">

<div class="col-sm-12">

<label class="cp_label" for="cp_present">Present:</label>

<textarea class="form-control" name="cp_present" id="cp_present" rows="10" style="width: 100%;"></textarea>

</div>

</div>

<div class="row">

<div class="col-sm-12">

<label class="cp_label" for="cp_apologies">Apologies:</label>

<textarea class="form-control" name="cp_apologies" id="cp_apologies" rows="10" style="width: 100%;"></textarea>

</div>

</div>

</div>

<div class="cp_whiteBox">

<h2>PATIENT'S/RELATIVE'S PERCEIVED NEEDS</h2>

<p>Long-term priorities identified as:</p>

<div class="row">

<div class="col-sm-12">

<label class="cp_label" for="cp_needs_1">1)</label>

<textarea class="form-control" name="cp_needs_1" id="cp_needs_1" rows="10" style="width: 100%;"></textarea>

</div>

</div>

<div class="row">

<div class="col-sm-12">

<label class="cp_label" for="cp_needs_2">2)</label>

<textarea class="form-control" name="cp_needs_2" id="cp_needs_2" rows="10" style="width: 100%;"></textarea>

</div>

</div>

<p>In the shorter term the priorities were identified as:</p>

<div class="row">

<div class="col-sm-6">

<label class="cp_label" for="cp_priorities_1">1.</label>

</div>

<div class="col-sm-6" style="margin-top: 15px;">

<input type="text" name="cp_priorities_1" id="cp_priorities_1" class="form-control" style="width: 100%;"></input>

</div>

</div>

<div class="row">

<div class="col-sm-6">

<label class="cp_label" for="cp_priorities_2">2.</label>

</div>

<div class="col-sm-6" style="margin-top: 15px;">

<input type="text" name="cp_priorities_2" id="cp_priorities_2" class="form-control" style="width: 100%;"></input>

</div>

</div>

<div class="row">

<div class="col-sm-6">

<label class="cp_label" for="cp_priorities_3">3.</label>

</div>

<div class="col-sm-6" style="margin-top: 15px;">

<input type="text" name="cp_priorities_3" id="cp_priorities_3" class="form-control" style="width: 100%;"></input>

</div>

</div>

<div class="row">

<div class="col-sm-6">

<label class="cp_label" for="cp_priorities_4">4.</label>

</div>

<div class="col-sm-6" style="margin-top: 15px;">

<input type="text" name="cp_priorities_4" id="cp_priorities_4" class="form-control" style="width: 100%;"></input>

</div>

</div>

<div class="row">

<div class="col-sm-6">

<label class="cp_label" for="cp_priorities_5">5.</label>

</div>

<div class="col-sm-6" style="margin-top: 15px;">

<input type="text" name="cp_priorities_5" id="cp_priorities_5" class="form-control" style="width: 100%;"></input>

</div>

</div>

</div>

<div class="cp_whiteBox">

<h2>PROFESSIONAL'S COMMENTS</h2>

<p><b>Long-term priorities:</b></p>

<div class="row">

<div class="col-sm-12">

<label class="cp_label" for="cp_proffComments_1">1)</label>

<textarea class="form-control" name="cp_proffComments_1" id="cp_proffComments_1" rows="10" style="width: 100%;"></textarea>

</div>

</div>

<div class="row">

<div class="col-sm-12">

<label class="cp_label" for="cp_proffComments_2">2)</label>

<textarea class="form-control" name="cp_proffComments_2" id="cp_proffComments_2" rows="10" style="width: 100%;"></textarea>

</div>

</div>

<p><b>Goals to be achieved in the coming weeks:</b> <i> relate back to each short term objective</i></p>

<div class="row">

<div class="col-sm-12">

<label class="cp_label" for="cp_shortTerm_1">1)</label>

<textarea class="form-control" name="cp_shortTerm_1" id="cp_shortTerm_1" rows="10" style="width: 100%;"></textarea>

</div>

</div>

<div class="row">

<div class="col-sm-12">

<label class="cp_label" for="cp_shortTerm_2">2)</label>

<textarea class="form-control" name="cp_shortTerm_2" id="cp_shortTerm_2" rows="10" style="width: 100%;"></textarea>

</div>

</div>

<div class="row">

<div class="col-sm-12">

<label class="cp_label" for="cp_shortTerm_3">3)</label>

<textarea class="form-control" name="cp_shortTerm_3" id="cp_shortTerm_3" rows="10" style="width: 100%;"></textarea>

</div>

</div>

<div class="row">

<div class="col-sm-12">

<label class="cp_label" for="cp_shortTerm_4">4)</label>

<textarea class="form-control" name="cp_shortTerm_4" id="cp_shortTerm_4" rows="10" style="width: 100%;"></textarea>

</div>

</div>

<div class="row">

<div class="col-sm-4">

<label class="cp_label" for="cp_goals_1">Goals in relation to those needs</label>

<textarea class="form-control" name="cp_goals_1" id="cp_goals_1" rows="10" style="width: 100%;" placeholder="E.g. liaise with X, Ongoing physio, Referral to welfare rights, Maintain weight"></textarea>

</div>

<div class="col-sm-4">

<label class="cp_label" for="cp_goals_2">Professional Involved</label>

<textarea class="form-control" name="cp_goals_2" id="cp_goals_2" rows="10" style="width: 100%;" placeholder="By each of goal"></textarea>

</div>

<div class="col-sm-4">

<label class="cp_label" for="cp_goals_3">Patient Action</label>

<textarea class="form-control" name="cp_goals_3" id="cp_goals_3" rows="10" style="width: 100%;" placeholder="e.g. X to keep a food diary for 1 week Attend scheduled sessions"></textarea>

</div>

</div>

<div class="row">

<div class="col-sm-12">

<label class="cp_label" for="cp_Notes">Notes</label>

<textarea class="form-control" name="cp_Notes" id="cp_Notes" rows="10" style="width: 100%;"></textarea>

</div>

</div>

<div class="row">

<div class="col-sm-12">

<label class="cp_label" for="cp_nextMeeting">Next Meeting</label>

<textarea class="form-control" name="cp_nextMeeting" id="cp_nextMeeting" rows="10" style="width: 100%;"></textarea>

</div>

</div>

</div>

</div>