The role of personalised professional relations across care sectors in achieving high continuity of care

Abstract

Background High continuity of care has a positive impact on health outcomes, but insight into the mechanisms underlying this impact is limited. Information continuity, on which our study focuses, is especially important when relational continuity is not given, which is often the case at hospital admission or hospital discharge. The aim of this study is to provide insight into the information flows between general practices and hospitals in Germany, and to identify factors associated with these flows of information. Methods This is a qualitative interview study in a purposeful sample of staff from hospitals and general practices (general practitioners, care assistants in general practice, hospital management, hospital physicians, and nursing staff). Interviews were conducted via telephone or face-to-face using a self-developed semi-structured interview guide. Stepwise systematic content analysis was used to structure collected material into themes and sub-themes that related to the study aim. Data was analysed by two researchers in several cycles, alternating between inductive and deductive approaches. Results A total of 49 interviews were conducted. Duration of the interviews varies between 21 and 78 min (mean duration 43 min). Across all groups, more than two thirds of participants were female (n = 34, 69%). The analysis highlighted six interdependent main themes regarding factors that affect information flows between hospitals and general practices: organisational, legal, financial, patient factors, individual characteristics, and emotional & social factors. The latter theme emerged as particularly rich and was therefore divided into four subthemes: appreciation and understanding of the respective other, (intrinsic) motivation, socialisation, and relationships. Organised meetings and events were mentioned as strategies to address emotional and social factors. Conclusions Digitalisation can facilitate information flows between care providers. However, knowing each other and good personal relations remain important for effective collaboration. Cooperation between all stakeholders is needed to aim to achieve continuity of care. Trial registration: DRKS00015183 on DRKS/ Universal Trial Number (UTN): U1111-1218–0992. Date of registration 23/08/2018.

Hospital Admission and Discharge: Lessons Learned from a Large Programme in Southwest Germany

“…Personal contact, i.e. via telephone, is not required and thus depends on individual motivation [25]. The legal regulation mentioned above aims at standardising and improving hospital discharges (Rahmenvertrag Entlassmanagement, § 39 Abs.…”

Zwischen neuer Verantwortung und Routinetätigkeit: Die Rolle der VERAH in der hausärztlichen Versorgung – Eine qualitative Sekundärdatenanalyse am Beispiel des softwaregestützten Case Management

“…In der Analyse wurden induktive und deduktive Schritte verbunden 1126 ▶ tab. 1 Übersicht Datenquellen/Material (Daten aus: [24,28] Das Aufgabenspektrum und das Ausmaß der Verantwortung für diese Tätigkeiten sind unterschiedlich. Einige VERAHs beschreiben sich als die Hauptbetreuenden im sCM und sehen sich in einer Koordinatoren-und Vermittlerfunktion zwischen Ärzt:innen und Patient:innen bzw.…”

“…In der Analyse wurden induktive und deduktive Schritte verbunden ▶tab. 1 Übersicht Datenquellen/Material (Daten aus: [24,28] Originalarbeit Thieme [29]…”

The Influence of Provider Connectedness on Continuity of Care and Hospital Readmissions in Patients With COPD: A Claims Data-Based Social Network Study

“…An interview study found that knowing each other and having personal relationships are important for effective information flow, communication, and collaboration between health professionals and, thus, for achieving patient CoC (informational and management CoC). 18 Possible underlying mechanisms could be that through recurrent interactions, a common understanding about information flow and coordination about patients is negotiated and care is, thus, improved. The impact of those relational attributes, which can be summarized under the term provider connectedness, can be measured and analyzed by applying social network analysis (SNA).…”