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Quality Improvement

Update and Action Care Plan

Using the Innovative Practices Evaluation Framework, Health Quality Ontario’s Health Links Clinical Reference Group has endorsed the following innovative practice or practices. Please click on the link(s) below to discover the steps for implementation, and to access resources that Health Links have used to successfully implement these practices.


Document the Coordinated Care Plan Using the Care Coordination Tool

One of the key outputs of Coordinated Care Management is the development of a Coordinated Care Plan (CCP). As described by the Ontario Medical Association, “a coordinated care plan is a written or electronic plan that is created and maintained by the patient or his or her family, the health care team including physician consultants where appropriate, and when necessary, community services. […] It outlines the patient’s short and long-term needs, recovery goals, and coordination requirements, and it identifies who is responsible for each part of the plan.” 1


Document Links:



1 Ontario Medical Association. Key Elements to Include in a Coordinated Care Plan [Internet]. Ontario: Ontario Medical Association. 2014 June [cited 2016 June]. Available from: https://www.oma.org/Resources/Documents/CoordinatedCarePlan_June2014.pdf

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