Develop a 3-4 page preliminary care coordination plan for a selected health care problem. Include physical,
psychosocial, and cultural considerations for this health care problem. Identify and list available community
resources for a safe and effective continuum of care.
NOTE: You are required to complete this assessment before Assessment 4.
The first step in any effective project is planning. This assignment provides an opportunity for you to strengthen
your understanding of how to plan and negotiate the coordination of care for a particular health care problem.
Include physical, psychosocial, and cultural considerations for this health care problem. Identify and list
available community resources for a safe and effective continuum of care.
As you begin to prepare this assessment, you are encouraged to complete the Care Coordination Planning
activity. Completion of this will provide useful practice, particularly for those of you who do not have care
coordination experience in community settings. The information gained from completing this activity will help
you succeed with the assessment. Completing formatives is also a way to demonstrate engagement.
Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the course competencies
through the following assessment scoring guide criteria:
Competency 1: Adapt care based on patient-centered and person-focused factors.
Analyze a health concern and the associated best practices for health improvement.
Competency 2: Collaborate with patients and family to achieve desired outcomes.
Describe specific goals that should be established to address a selected health care problem.
Competency 3: Create a satisfying patient experience.
Identify available community resources for a safe and effective continuum of care.
Competency 6: Apply professional, scholarly communication strategies to lead patient-centered care.
Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation,
word choice, and spelling.
Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.
Preparation
Imagine that you are a staff nurse in a community care center. Your facility has always had a dedicated case
management staff that coordinated the patient plan of care, but recently, there were budget cuts and the case
management staff has been relocated to the inpatient setting. Care coordination is essential to the success of
effectively managing patients in the community setting, so you have been asked by your nurse manager to
take on the role of care coordination. You are a bit unsure of the process, but you know you will do a good job
because, as a nurse, you are familiar with difficult tasks. As you take on this expanded role, you will need to
plan effectively in addressing the specific health concerns of community residents.