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Unit 20 Care planning process in
healthcare practice
Session 7
Objectives
• L03 Review the challenges and benefits of planning person-centred
care in the workplace.
• Focus on strategies developed to overcome any barriers to
implementing care plans
• Last session a critical review on challenges to planning person centred
care and in care planning was discussed in association with the
benefits of following a person centred care.
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Strategies for overcoming barriers in care
planning/ promoting person centred care
• Working in partnership approaches and effective communication in
resolving challenges:
• Training and workforce development
• Agreed ways of working in teams, clarity of roles and responsibilities
• Agreed outcomes
• Input from individual and family, friends and carers
• Target setting:
• SMART (specific, measurable, achievable, realistic, timely) targets
• Risk assessment

• Definition An interactive, collaborative process between providers and patients that is used to make healthcare decisions in which at least 2 individuals work together as partners with mutual expertise to exchange information and clarify values in relation to options and thereby arrive at a discrete decision. In principle working in partnership with service users, families , and various health care professionals can solve problems and challenges in promoting person centered care.

• Partnership • Practitioner as an advocate to the patient • Identifying, supporting and addressing the needs of the individual • Helping to provide information • To discuss options • To clarify values and preferences • To support consumer autonomy • Provide a care plan that is agreed

GOAL A person-centered, supportive encounter which promotes the ideal conditions for effective decision making to occur Patients are empowered with information so that their autonomy or control over healthcare decision making is increased

Shared Decision Making (SDM) – Working in
partnership with MDT team and families

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How SDM Supports Patient
Empowerment and Participation
In the shared decision-making process, practitioners are encouraged to think
about and apply:
1. Self-directed care
2. Self-determination
3. Person-centered planning
For patients to participate fully as partners in a shared decision making
process, they will need to accurate information, skills, and confidence
Steps in a Shared Decision Making Process
1. Recognition that a decision needs to be made
2. Identification of the partners in the process as equals
3. Statement of options as equal
4. Exchange of information on pros and cons of options
5. Exploration of understanding and expectations
6. Identifying preferences
7. Negotiating options and concordance
8. Sharing the decision
9. Arranging follow-up to evaluate decision making outcomes
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Solution-Focused Decide what the person wants instead of what they don’t want—when what the person is doing is not working, have him or her do something different.

Stage of Change  In contemplation: aware of the problem, but ambivalent about making a change “How important do you think it is to others— family, friends, doctor— that you consider making these changes for your health?”

Empowerment Identification of something YOU (the patient) want to accomplish or a problem that you want to resolve

Recognition that a decision needs to be made
Matching Techniques and Approaches to the
Shared Decision Making Process
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Solution-Focused Amplify and build on strengths to promote change in areas identified by the person and the view he/she holds for wanting things to be different  Practitioners and patients construct the solutions together …sometimes inventing them

Stage of Change Providers respect the particular needs of persons in various stages and adjust their stance (nurturing parent, Socratic teacher, coach, consultant) to support specific actions necessary for the person to progress to the next stage

Empowerment Persons are allowed to direct their own course, focusing on one or two items that fit their interest or need  This process will generate feelings of self efficacy, competence and build confidence

Identification of the partners in the process as equals 7
Matching Techniques and Approaches…
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Benefits of effective communication in person
centred care
• First, it greatly contributes to the ability to provide patients with personalised
care. Health care professionals who take the time to understand the unique
challenges and concerns of their patients will be better prepared to advocate on
their behalf and properly address issues as they arise. This greater focus on
communication frequently leads to better patient outcomes as well as a good
continuity of care.
• Effective communication improves responsiveness of service users and they are
more likely to disclose the true extent of their feelings and symptoms much
quicker. Patients may also feel more satisfaction and feel valued.
• Interpersonal communication can satisfy the innate needs of the patient as
outlined in Maslow’s hierarchy of needs. Maslow (1962) Those needs include the
feelings of safety, love and confidence, all of which are important during a
patient’s treatment and recovery.
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• Effective partnership working and good communication between everyone
is essential. Health and social care workers must trust, value and respect
one another, having belief in everyone’s ability to work together to achieve
shared goals.
• For communication to be good and effective it must be open, accurate and
understandable.
• Ways of communicating and language must be right for the individual so
you can be sure that they understand what is being said. Workers should
avoid using jargon which can be misunderstood.
• When working with people who have communication needs, it may be
necessary to consider translators, pictures or communication boards to
support them to communicate well.
Training staff
• The ultimate goal of a training program is not just to increase the skills
of health care workers, but also to help health care
providers recognize and report problems that could impact the health,
safety and well-being of all individuals who require health care.
• Training staff improves the quality of care of staff members
• Training staff enables health care workers more capable in to provide
holistic care and person centred care.
• Improve CQC rating, and organisation are meeting the requirement of the
law and regulatory bodies.
• Training staff increases loyalty and employee engagement
• Training staff improves competences, knowledge , skills and abilities.
• Training improves Dignity and choices for resident.
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Health care workers should agree on how
• Providing care and support
• Working in a person-centred way
• Communicating well
• Building relationships and promoting equality and diversity
• Working as part of a team
• Being a supportive team member and developing your skills to improve your work
• Contributing to activities in a safe way
• Keeping and filing clear records
• Keeping to regulations
• Following the agreed way of working
• Respecting confidentiality by not discussing any personal information on individuals or
staff with unauthorised people, and storing records securely
• Action planning – creating SMART goals depending on your weakness
and plan for improvement.
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• Goal setting: what do we want to achieve and by when?
• Action planning: what are we going to do, who is responsible, and
when will it be reviewed?
SMART is a well-known acronym for Specific, Measureable,
Attainable/Achievable, Relevant/Realistic and Timebound/Timely/Time limited (Basi and Green, 2016)
. It has been used to support systematic planning in many areas
including health, business, and education. It can help you to develop
plans that are clear, can be implemented, and can be evaluated.
Group work
• Using the SMART target setting process in care planning.
• Read the article and guideline and answer the scenario
• Share your responses to the class.
• Assess your work place setting and share if there any other solutions
or strategies used to deal with barriers in care planning or person
centred care.
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• Basi, J. and Green, C. (2016). Writing good care plans. [online]
Oxleas.nhs.uk. Available at: http://oxleas.nhs.uk/site-media/cmsdownloads/Writing_Good_Care_Plans_Oxleas.pdf [Accessed 6 Nov.
2019].
• Maslow, A. H. (1962). Toward a psychology of being. Princeton: D. Van
Nostrand Company