Client experience with care plan involvement

How clients rated their involvement in making their care plan. (see data dictionary)

What do you think?

  • Why does client involvement in care planning matter?
  • How might this information be used to inform Continuing Care Health Service Standards 1.0 Standardized Assessment and Person-Centred Care Planning and 2.0 Case Management, and/or related sub-standards?
  • Are there differences between zones? Between mainly rural and urban zones? What factors could account for these differences?

Whether you’re a client, family member, provider, or health system administrator, thinking about why these differences might exist can start or inform conversations and lead to solutions for improved quality of healthcare.

Understanding “care plan involvement”

In a survey conducted from October 2018 to March 2019, the HQCA asked clients receiving home care:

In the last year, I was involved in making my Care Plan.

Clients could choose “Yes a lot / Yes a little / No, not at all / No, I don’t think I should be involved

A care plan describes both the professional and personal services that will address a home care client’s care assessed unmet needs, which means the care plan is informed by the results of a standardized assessment and the client’s preferences (e.g., spiritual and cultural). Case managers facilitate the development of a care plan with the home care client and their family, loved ones, or caregivers.

From the HQCA survey results, better overall home care experiences were reported by clients who felt they were involved in making their care plan.

Considerations when viewing the results:

This data reflects the experiences of seniors aged 65+ receiving long term supportive and maintenance care and are among the largest groups of home care clients.

There are a number of factors providers and leaders can consider to better understand and improve client experiences with being involved in the development of their care plan. Some questions they could ask before taking action include:

  • How do clients define “being involved” in making their care plan? What are some common experiences among clients who felt sufficiently involved?
  • What aspects of making a care plan are most important for clients and their loved ones to be involved in, from both the case manager and client’s perspective?
  • How might the timing of engaging clients and their loved ones make a difference? What are the benefits to starting discussions about the opportunities and limitations to being involved in making a care plan before beginning care planning activities?
  • How does client involvement in making their care plan improve the delivery of quality, person-centred, and safe care?
  • When clients are involved in making their care plan, what impact can this have on their understanding and expectations of care?
  • What are some challenges to involving clients in making their care plan? Many teams and patients are incorporating elements of the “What matters to you?” campaign to help overcome challenges to client involvement. How might this create engagement opportunities in your context?
  • Why is it important for a home care client to see their care plan? What are some potential impacts to clients’ experiences of care if they have not seen their care plan? Does the client have a copy of or access to their care plan?
  • How are case managers encouraged and supported to overcome these challenges to engage their clients and their family, loved ones, or caregivers in care planning?
  • If a client does not want to be involved in making their care plan, how can case managers develop a care plan that results in a positive client experience?

For information about the HQCA’s Alberta Seniors Home Care Client Survey, please visit the HQCA website.

The Health Quality Council of Alberta uses the Alberta Quality Matrix for Health as a way of organizing information and thinking around the complexity of the healthcare system. This measure can be used as input to assess home care’s performance in these dimensions of quality:
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Dimensions of Quality

  • Acceptability 
  • Accessibility 
  • Appropriateness 
  • Effectiveness 
  • Efficiency 
  • Safety