Continuity of care requires an integrated approach to care. Professionals and health care institutions accept the ongoing responsibility of caring for dying patients. The health care aide who visits a patient on Monday also visits the patient on Wednesday. The treatment plan used at home is followed in the hospital. A patient being cared for in an integrated system does not have to explain to ER staff that she is enrolled in hospice. No one has to search for a DNAR order - and one order is honored everywhere. The system operates cohesively and coherently, and patients and families trust providers - and the health care system - depending on it for care best suited to their disease and circumstance. In this system, all members share a commitment to key elements of care, such as pain relief or bereavement support.
|Some Elements of Coordinated Care|
(Source Institute of Medicine, 1997)
7.4.1 Case Study - EverCare Program, United HealthCare Corporation
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This online version of the book Improving Care for the End of Life: A Sourcebook for Health Care Managers and Clinicians is provided with permission of Americans for Better Care of the Dying [ www.abcd-caring.org ] and Oxford University Press. All rights reserved.
For further information on quality improvement in end-of-life care visit The Palliative Care Policy Center [ www.medicaring.org ].