Complex care discharge planning initiative for complex patients with anticipated LOS 4 days This PATIENT CARE PLAN is to be given to the patient 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering the patient's personal information, including their name, date of birth, and telephone number. Ensure accuracy as this information is crucial for follow-up care.
  3. Fill in the details of the most responsible physician and primary health care provider, including their contact numbers. Confirm that the primary health care provider was notified within the first 24 hours post-admission.
  4. Document the admitting diagnosis, discharge diagnosis, and any other relevant diagnoses. This section helps in understanding the patient's medical history.
  5. List any medications prescribed at discharge along with allergies and any changes made to existing medications. Use clear notes for each entry.
  6. Indicate follow-up appointments arranged for both primary and specialist care. Specify if home care is required and provide a contact person if necessary.
  7. Complete any special instructions for both the patient and their primary health care provider. Include triggers for re-referral or advice as needed.

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