care plan

dynamic, personalized plan including identified needed care activity, intended outcomes and care goals, relating to one or more specified health needs in a care process

Table 1. Associations of care plan
Source multiplicitySource classAssociationTarget classTarget multiplicity
1..*care planaddresseshealth issue1..*
1..*care planaddresses (1)health thread1..*
0..*care planbased uponcore care plan1..*
0..*care planaggregation ofcare plan0..*
0..*care planconforms tocare guideline0..*
1..*care planrecorded inhealth record1..*
1..*care planresult ofcare planning1..*
1..*care plantargetsintended outcome1..*
0..*care activity bundleaggregation ofcare plan1..*
0..*care actorappliescare plan1..*
0..*care appointmentscheduled incare plan0..*
0..*care goalaggregation ofcare plan1..*
1..*care processplanned incare plan1..*
0..*protocolaggregation ofcare plan0..*
Figure 1. Class Diagram
Class Diagram of care planGenerated diagram of focal class care plan and related classes. 0..* 0..* complies with 1..* 0..* set of care activitiescare activity bundle 1..* 0..* applies organization or person participating in carecare actor 0..* 0..* scheduled in appointment for a contactcare appointment 1..* 0..* desired achievement of one or more care activitiescare goal 1..* 1..* planned in set of interrelated or interacting care activities which transforms inputs into outputscare process 0..* 0..* customized care guidelineprotocol 0..* 0..* conforms to set of systematically developed statements based on knowledge to assist the decisions made by care actors about care activities to be performed with regard to specified health issuescare guideline 1..* 1..* result of care activity management where a care plan is managedcare planning 1..* 0..* based upon knowledge providing reusable content addressing one or more specified health issuescore care plan 1..* 1..* addresses health condition motivating carehealth issue 1..* 1..* recorded in data repository regarding the health and care of a subject of carehealth record 1..* 1..* addresses defined association between health matters as determined by one or more care actorshealth thread 1..* 1..* targets desired achievement of a care process addressing health needsintended outcome dynamic, personalized plan including identified needed care activity, intended outcomes and care goals, relating to one or more specified health needs in a care processcare plan care plan crossing organizational, professional and contextual bordersintegrated care plan care plan addressing social issuessocial care plan care plan addressing clinical issuesclinical care plan

Example 1 Integrated care plan.

Example 2 Plan to address one vulnerability.

Example 3 Plan for a single contact.

Example 4 Plan for social care activities to be performed by one care provider within a social care context.

Example 5 A social worker care plan with the constraint of only one specific social care provider involved.

Note 1 A care plan can be subdivided from different perspectives by different constraints.

Synonym care plan