GUIDELINE FOR THE USE OF THE RECORD FOR INTERDISCIPLINARY PLAN OF CARE (IPO) PROCESS

1. Attach patient identification label to all copies.
2. Document anticipated discharge date.
3. Sections 1-19, RN completes prior to IPOC meeting.

KP:  Interdisciplinary team addresses all No Responses and identifies goals at IPOC meeting.

4. Remaining sections are addressed and documented at the IPOC meeting.

KP:  Interdisciplinary team collaborates identifying patient needs and discharge goals related to sections 20-36.

5. Sections labeled "other" are used for topics not listed or unique goals identified.
6. Current Resources or Equipment - document identified patient resources, i.e. family support, home health, home equipment prior to this admission and equipment required at discharge.
7. Follow Up Assignments/Notes - document identified patient issues for IPOC member to follow up on.  Person completing assignment will initial on IPOC within 24 hours or document why task was not completed.
8. Potential Barrier(s) to Discharge - document indentified barrier, i.e. transportation, completion of diagnostic testing and consults.
9. Identify discharge designation with check mark in appropriate box.
10. Disciplines in attendance are indicated in appropriate section with check.
11. Person completing form and validating attendance of meeting places signature and date in lower left side of page in space provided.

FOLLOW UP RECORD

KP:  Form used as continuation of Interdisciplinary Plan of Care Process

1. Attach patient identification label to all copies.
2. Document anticipated discharge date.  Prior to IPOC meeting RN reviews sections 1-19 on page 1 and changes identified are documented in Issues section requiring followup from last IPOC meeting.
3. New issues requiring follow up to discharge document new identified patient needs or needs requiring further follow up or screening.
4. Follow-up Assignements/Notes-document a follow up issue and person assigned.
5. Potential Barriers to Discharge - document new barriers or status of previously identified barriers that remain active.
6. Disciplines in attendance are indicated in appropriate section.
7. Patient progressing per care plan is discussed and IPOC members collaborate on yes or no answer.
8. Person completing form and validating attendance of meeting places signature and date in spact provided.

KP:  Follow up record of IPOC Process has space provided for two IPOC meetings.

KP:  IPOC members sign the Clinical Program Education Department Attendance Record.  Facilitator of meeting will forward to Staff Education to place in Training Tracker.

RESOURCE PERSON(S):   Joyce Randof, RN, MNSc, BC