About this resource
When several disciplines are involved, separate plans can overlap or conflict. This template creates one shared plan: the person's goals and preferences, how they like to communicate, each discipline's contribution, a key contact, communication arrangements and review dates.
Purpose
To bring discipline-specific plans together into one coherent, person-led plan.
Who it is for
Primary profession: Allied health and multidisciplinary teams. Also relevant for NDIS providers and support coordinators, occupational therapists.
Client or participant group: Multidisciplinary teams and the people they support.
Practice setting: Community health, rehabilitation, disability and aged care services.
Suggested uses
- Creating a shared plan at the start of a service
- Coordinating community and hospital teams
- Reviewing and updating plans
- Sharing an accessible version with the person
Instructions for practitioners
- Start with the person's goals and preferences in their words.
- Ask each discipline to describe its contribution to each goal.
- Nominate a key contact for the person and team.
- Agree communication and review dates.
- Share an accessible version with the person.
Accessibility considerations
Provide the person's copy in plain language or Easy Read and confirm understanding.
Scope and limitations
A care planning template. It does not replace discipline-specific documentation, clinical governance or consent processes.
Research basis
Interprofessional collaboration interventions may improve professional practice and outcomes, although the evidence is still limited. Shared decision-making and decision aids help people understand options and make choices that reflect their values. Specific goals, if-then plans and regular progress monitoring all improve the chances of reaching goals.
- Elwyn, G., Frosch, D., Thomson, R., Joseph-Williams, N., Lloyd, A., Kinnersley, P., Cording, E., Tomson, D., Dodd, C., Rollnick, S., Edwards, A., & Barry, M. (2012). Shared Decision Making: A Model for Clinical Practice. Journal of General Internal Medicine, 27(10), 1361–1367. https://doi.org/10.1007/s11606-012-2077-6
- Gollwitzer, P. M., & Sheeran, P. (2006). Implementation Intentions and Goal Achievement: A Meta‐analysis of Effects and Processes. Advances in Experimental Social Psychology, 69–119. https://doi.org/10.1016/s0065-2601(06)38002-1
- Harkin, B., Webb, T. L., Chang, B. P. I., Prestwich, A., Conner, M., Kellar, I., Benn, Y., & Sheeran, P. (2016). Does monitoring goal progress promote goal attainment? A meta-analysis of the experimental evidence. Psychological Bulletin, 142(2), 198–229. https://doi.org/10.1037/bul0000025
- Locke, E. A., & Latham, G. P. (2002). Building a practically useful theory of goal setting and task motivation: A 35-year odyssey. American Psychologist, 57(9), 705–717. https://doi.org/10.1037/0003-066x.57.9.705
- Reeves, S., Pelone, F., Harrison, R., Goldman, J., & Zwarenstein, M. (2017). Interprofessional collaboration to improve professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews, Article CD000072. https://doi.org/10.1002/14651858.cd000072.pub3
- Stacey, D., Légaré, F., Lewis, K., Barry, M. J., Bennett, C. L., Eden, K. B., Holmes-Rovner, M., Llewellyn-Thomas, H., Lyddiatt, A., Thomson, R., & Trevena, L. (2017). Decision aids for people facing health treatment or screening decisions. Cochrane Database of Systematic Reviews, Article CD001431. https://doi.org/10.1002/14651858.cd001431.pub5
What is included
A 3-page printable A4 PDF, including a practitioner notes page with the research basis (version 1.0).
Originality
Original Practitioner Plus content: wording, activity structure, layout and icons were created for this resource. No third-party worksheets, illustrations or text were reproduced.
