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Downtown East Toronto
Coordinated Care Planning Resources



For more information contact Dorothy Wedel at Dorothy.wedel@unityhealth.to

Ontario is improving care for people with complex conditions through coordinated care planning. This innovative approach brings together health and other social service providers to better and more quickly coordinate care for high-needs patients.

What does coordinated care planning do for patients?

  • A shared understanding of patients goals, conditions and medications
  • Smoother transitions between contexts such as hospital to community
  • Greater patient involvement in shaping care
  • Ongoing relationships between providers
  • An evolving care plan as needs change
  • More accessible services
  • A reduction in avoidable hospital utilization

Patients living with complex health issues have multiple providers across numerous sectors, and benefit from highly integrated and coordinated care. Poorly coordinated care has been identified as a significant cause of adverse health outcomes and rising health care costs. Coordinated care reduces gaps in the care of patient/clients with multiple chronic conditions.

What is unique about coordinated care planning?

  • Places the patient’s goals at the centre of care planning
  • Determines a provider responsible for taking the lead in coordinating care
  • Supports providers to work with each other and with the patient to develop an individualized Coordinated Care Plan (CCP)
  • Facilitates access and attachment to primary care
  • Enable ongoing communication and collaboration within the circle of care

Coordinated care planning materials for providers and patients

For more information

Contact Dorothy Wedel, Mid-East Toronto project manager
Dorothy.wedel@unityhealth.to
416-867-7460 ext. 48303