---
title: "Goal Planning Care Plan"
canonical: "https://wiki.patientsknowbest.com/space/DEPLOY/3572990772/Goal%20Planning%20Care%20Plan"
format: markdown
---
> Macro (toc)

# 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 patients' goals was very disjointed, and patients didn't always get to 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 patient's 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

# Care Plan Template

![image](media://f68ae666-f532-47e0-8b85-24e3723b408d)

<details>
<summary>Example care plan template code for Joint Neuro Clinical Goal Planning Meeting Care Plan HTML</summary>

<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>
</details>