Planning roles and responsibilities of health personnel, as all parties involved with patient care service process must be systematically and continuously. The sale requires planning, knowledge and shared understanding of both the problems and the needs of the patient. The ability of the family. The patient's dependence on global disease issues that need nurses. The occupational health training, physical therapy, speech training. Social service support requirements, including knowledge of The services must be continued at home. Discharge plan of the patient that is defined in a hospital while receiving treatment will need to be placed on the patient to plan a short term plan patients sold. During the acute symptoms and continuous care plan risk for disease, which is a long-term plan to help encourage patients and caregivers to learn best practices and ensure their own health and family under the context. Home and family itself.