Coordinating care is a strategy that can improve the effectiveness, safety, and the efficiency of healthcare. Targeted and well-designed coordinated care that is delivered to the right people can improve outcomes for everyone.
The main goal of care coordination is to meet the patient’s needs and preferences while delivering high-quality, valued health care. This means that the patient’s needs and preferences are known and communicated to the providers treating them, and this information is then used to guide the delivery of safe, appropriate, and effective care.
- A comprehensive care plan for all health issues typically includes, but is not limited to, the following elements:
- Problem list
- Expected outcome and prognosis
- Measurable treatment goals
- Symptom management
- Planned interventions and identification of the individuals responsible for each intervention
- Medication management
- Community/social services ordered
- A description of how services of agencies and specialists outside the practice are directed/coordinated
- Schedule for periodic review and, when applicable, revision of the care plan