Partner in Health |
No. of questions answered |
0 (no questions) |
1 (1–11) |
2 (all questions) |
|
|
Cue and Response |
Scored by health practitioner |
0 (none) |
1 (some) |
2 (all) |
|
|
Scored by client |
0 (none) |
1 (some) |
2 (all) |
|
|
Notes provided around scores < 4 or discrepancy > 3 |
0 (none) |
1 (some) |
2 (all) |
|
|
Enough notes on discussion of scores |
0 (no notes) |
1 |
2 (limited notes) |
3 |
4 (detailed notes) |
Notes are written from client’s perspective |
0 (none) |
1 |
2 (reflects client perspective) |
3 |
4 (client’s own words) |
Identified issues transferred to care plan |
0 (none) |
1 (some) |
2 (all) |
|
|
Problem and Goals |
Problem statement |
0 (neither) |
1 |
2 (succinct or first person) |
3 |
4 (succinct and first person) |
Response to problem |
0 (none) |
1 |
2 (reflects client perspective) |
3 |
4 (client’s own words) |
Appropriate impact response |
0 (absent) |
1 |
2 |
3 |
4 (describes what happens) |
Appropriate feeling response |
0 (absent) |
1 |
2 |
3 |
4 (describes feelings) |
Problem statement |
0 (no response) |
1 |
2 |
3 |
4 (all response to open questions are reflected) |
Client scored problem |
0 (none) |
1 (scored 0,1,2) |
2 (scores > 3) |
|
|
Medium to long-term goal statement |
0 (no response) |
1 |
2 |
3 |
4 (linked to problem statement |
Goal |
0 (absent) |
1 (either positive or regular activity) |
2 (both positive and regular) |
|
|
SMART goal |
0 (absent) |
1 (some elements) |
2 (all elements) |
|
|
Client scored goal |
0 (no score) |
1 (scored 6, 7 or 8) |
2 (scored < 6) |
|
|
Care Plan |
Transfer of problem statement and score |
0 (absent) |
1 (transferred problem statement or score) |
2 (transferred both elements) |
|
|
Transfer of goal statement and score |
0 (absent) |
1 (transferred goal statement or score) |
2 (transferred both elements) |
|
|
Language |
0 (technical language and jargon) |
1 |
2 |
3 |
4 (client’s own words, avoiding technical language and jargon) |
Management aims – what client wants to achieve |
0 (none) |
1 |
2 (not clinically focused) |
3 |
4 (present) |
Manageable Interventions |
0 (none) |
1 |
2 |
3 |
4 (small steps) |
Client’s name |
0 (absent) |
1 |
2 (present) |
|
|
Review date |
0 (absent) |
1 (some) |
2 (all) |
|
|