Rehabilitation planning is needed in any complex case, where complexity is demonstrated by the involvement of more than one or two people or (not and) by the need for a prolonged period of active intervention. Ideally it should occur when any person is first seen within a rehabilitation context, because it forces a consideration of long-term goals. Even if the patient is only seeing one professional perhaps six times over a couple of months, it is likely that discussing a plan with the patient and formally documenting it would improve efficiency and effectiveness and it might avoid missing important actions.
Planning usually requires the meeting, at the same time and, in normal circumstances, in the same place, of as many of the people or teams involved with the patient as possible. Notwithstanding the advice earlier that formulation should occur as part of the first stage, in reality it will inevitably and quite appropriately, also occur as part of any planning meeting.
Planning meetings are needed, because in any complex case many people will be involved, usually including people from other services and organisation, and always including family or friends. Actions will be needed from many people, and often actions are interdependent even if they do not have to be undertake simultaneously. Without a planning meeting, it is likely that actions will be overlooked or not identified, or forgotten.
The graphic shows, first, why meetings are needed. it then goes through the five stages detailed below. It ends by showing the outputs, the potential goals of the meeting. The specific purpose of any one meeting will determine its precise content and goals.
Stage one – share information
Stage two – prognosis and treatment
Stage three – set long- and medium-term goals
Stage four – agree short-term goals
Stage five – documentation
In addition to their professional knowledge and skills, and the information they bring, people attending the meeting need two other skills. The first, vital but only needed by one person, is to be able to chair or lead a meeting. Being a good chair of a (rehabilitation) planning meeting requires a host of skills:
- able to keep in mind the whole situation;
- using the biopsychosocial model framework as an aide memoire helps;
- avoiding the meeting becoming focused on minor issues;
- being able to keep everyone focused, stopping people who are repeating information or deviating from the topic;
- ensuring everyone present contributes and understands;
- not allowing professional jargon to be used;
- summarising; questioning; and
- ending the meeting with a clear action plan.
The other skill, needed by everyone involved in rehabilitation, is to be able to participate in planning meetings productively, giving information and opinions simply, clearly, and politely when needed but not repeating material already covered or talking about inessential matters.