Comprehensive care

Comprehensive care is the coordinated delivery of the total health care required with regard for a patient’s preferences. It may be a discrete episode of care or part of an ongoing comprehensive care plan. This health care is planned and delivered in collaboration with the patient. It considers the effect of the patient’s health issues on their life and wellbeing, and is clinically appropriate.

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Consumer outcome
My health care is safe, of high quality and is tailored to meet my needs and preferences.

Intention of this standard

Comprehensive care is the coordinated delivery of the total health care required with regard for a patient’s preferences. It may be a discrete episode of care or part of an ongoing comprehensive care plan. This health care is planned and delivered in collaboration with the patient. It considers the effect of the patient’s health issues on their life and wellbeing, and is clinically appropriate.

Multidisciplinary collaboration

3.19—The healthcare service:

  1. Collaborates with other healthcare providers involved in a patient’s care
  2. Supports collaboration with other care providers to develop a coordinated approach to the planning and delivery of health care
  3. Facilitates reporting to a patient’s other relevant care providers

Health promotion and prevention

3.20—The healthcare service has processes to support health education and promotion, illness prevention and early intervention for patients, considering its patient population

Planning and delivering comprehensive care

3.21—The healthcare service has processes to ensure healthcare providers work within their scope of practice to plan and deliver comprehensive care by:

  1. Conducting a risk screening and assessment
  2. Conducting a clinical assessment and diagnosis
  3. Identifying the patient’s goals of care
  4. Developing and agreeing a plan for care in partnership with the patient
  5. Delivering comprehensive care in accordance with the agreed plan for health care
  6. Recalling patients for follow-up health care when required
  7. Reviewing and improving the processes of comprehensive care delivery
  8. Receiving a current advance care plan and incorporating it into a patient’s healthcare record

3.22—The healthcare service has processes to:

  1. Routinely ask if a patient is of Aboriginal and/or Torres Strait Islander origin
  2. Record this information in the patient’s healthcare record
  3. Use this information to optimise the planning and delivery of health care

3.23—The healthcare service supports its workforce to meet the individual needs of its patients, including those:

  1. with disability
  2. from diverse populations

Comprehensive care at the end of life

3.24—Healthcare providers use a healthcare service’s processes that are consistent with the National Consensus Statement: Essential elements for safe and high-quality end-of-life care to:

  1. Identify patients who are at the end of life
  2. Use this information to plan and deliver health care