How Does Continuity of Care Work

Stable, consistent health services greatly increase quality of care and positive treatment outcomes. This is particularly true for nursing care. Continuity of care in nursing affects more stakeholders than one might imagine. Maintaining stable services, or continuity of care, increases in difficulty as the medical field grows more complex, especially when it involves patients who require the expertise of several specialists.

Learning about continuity of care in nursing can enable students in Master of Health Administration programs to understand one of the most important aspects of providing quality health care.

What Is Continuity of Care?

Continuity of care refers to health care professionals and patients cooperating in care management to achieve the goal of consistent, high-quality care. Ensuring continuity of care builds trust between patients and health care providers. Achieving continuity of care requires the support of leadership as well as strong management and governance processes. Continuity of care includes:

• Interpersonal continuity that ensures the same central providers take care of a patient's health needs
• Longitudinal continuity across each patient's health care experience from admission to discharge
• Management continuity across each step of a patient's case management
• Informational continuity that builds a consistent collective memory across providers and settings

Several factors can adversely affect continuity of care. Stable, consistent service is critical for the treatment and cure of serious health conditions. However, this need typically diminishes in parallel with the severity of a patient's condition. Additionally, health care professionals who establish a strong rapport with consumers are more likely to retain patients, and in effect maintain continuity of service.

Conversely, health care professionals who do not build a good rapport might lose patients regularly, disrupting continuity of service due to consumers seeking new care providers. In fact, patient satisfaction has historically influenced continuity of care.

Continuity of Care in Nursing

In the modern health care setting, the nursing staff plays a pivotal role in serving as a liaison among the many disciplines required to deliver services to patients. Nurses in particular are in a position to be patient advocates and coordinate with other members of health care teams to ensure continuity of care. They also have multiple interactions with patients, which places them in a unique position to help ensure that patients' needs are met within appropriate continuity of care. In addition, nurses have a keen awareness of health care communication channels and can be helpful in facilitating referrals.

Examinations for nursing licensure include segments on continuity of care in areas such as:

• Following up with patients after they are discharged
• Participating in patient discharges or transfers
• Recording patient information in medical records and on transfer and referral forms
• Guiding patient care using tools such as care maps and care plans

Advanced practice registered nurses (APRNs), who follow the transitional care model (TCM), are a specific example of how medical professionals can promote continuity of service. Under the TCM framework, APRNs might officially visit with consumers twice a week. Nurse practitioners also maintain contact with consumers regularly via phone, and are available to accept patient phone calls seven days a week.

The Role of Nurse Leaders in Ensuring Continuity of Care

Technology adopted by medical organizations is helping facilitate team collaboration and, in turn, continuity of care. While initial technology investments can prove expensive, health information technology (HIT) facilitates consumer education, promotes coordinated care, and streamlines treatment processes.

Health care administrators work to improve coordination of services between internal departments and external networks, and nurse leaders are instrumental in working with health care administrators to improve that coordination. Even within the same organization, care providers may unintentionally break continuity of care between medical units. To mitigate such occurrences, nurse leaders can promote an environment in which team members possess a shared understanding of organizational objectives and therefore work toward the same goals.

Nurse leaders are in a unique position to stress the importance of a philosophy of care that emphasizes continuity. They also can play a role in helping set policies and procedures that promote continuity of care.

Continuity of Care in Nursing Improves Patient Outcomes

Nurses' involvement in continuity of care has a positive impact on patient outcomes.

• Adding oncology nurse navigators to a multidisciplinary team to help ensure continuity of care has resulted in measurable reductions in the time between diagnosis and treatment.
• Nurse-lead geriatric TCMs have increased the time to first re-hospitalization or death, decreased the number of days hospitalized, and decreased costs.
• The use of nurse navigators across the continuum of care has been shown to reduce emergency room visits and hospital readmission.

Nursing Continuity of Care Is an Important Component of Health Administration

Continuity of care in nursing is critical to the well-being of patients in a variety of settings. It also can be instrumental in the successful administration of an entire health care organization.

Individuals who have an interest in pursuing health administration as a career, and learning more about conducting effective health administration, can explore the Regis College online Master of Health Administration (MHA) program.

Set forth on a path to health care leadership today.

Recommended Readings

7 Tips for Ensuring Patient Safety in Healthcare Settings

How to Become a Hospital Administrator

How to Become a Health Information Manager

Sources:

American Academy of Family Physicians, Continuity of Care, Definition of

American Association of Colleges of Nursing, What Every Nursing Student Should Know When Seeking Employment

BMC Geriatrics, "Components of the Transitional Care Model (TCM) to Reduce Readmission in Geriatric Patients: A Systematic Review"

Journal of Oncology Navigation Survivorship, "The Thoracic Oncology Nurse Navigator and Using a Multidisciplinary Approach to Improve Timeliness of Care of Lung Cancer Patients in a Community Medical Center"

National Council of State Boards of Nursing, Inc., NCLEX-PN Examination Test Plan for the National Council Licensure Examination for Practical Nurses

Oncology Nursing Society, Role of the Oncology Nurse Navigator Throughout the Cancer Trajectory

The Online Journal of Issues in Nursing, "Continuity of Care: The Transitional Care Model"

Sultan Qaboos University Medical Journal, Continuity of Care

World Health Organization, Continuity and Coordination of Care

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Source: https://online.regiscollege.edu/blog/continuity-of-care-nursing/

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