Continuity of care for older hospital patients

Consistent, reliable high-quality care is what all patients want and health workers aim to provide. However, the reality for most patients, particularly those in acute hospitals, often falls far short of the ideal. In the context of acute care, the risks of fragmentation and breakdown in care co-ordination are high, especially for older patients. This paper focuses on those aged 70 years and older with multiple health problems and explores how continuity of care affects them and the people closest to them.

Continuity of Care for Older Hospital Patients: A call for action outlines:

the current situation, including the fact that most patients in hospital are older, that the length of time they spend in hospital is directly related to age, that they are frequently moved around inside the hospital and are more likely to be re-admitted after discharge
why continuity of care is so difficult to achieve, including increasing specialisation in medicine and nursing; the fact that hospitals are under pressure to meet access targets, to increase productivity and to reduce lengths of stay
what good practice would look like, with recommendations on practical models and methods for improving continuity – eg, enrolling carers as partners in care, appointing a named key worker, ensuring patients and carers know which consultant is in charge of the patient’s care and how to reach them, use of documents such as ‘This is Me’, providing better training for staff.

In addition to reviewing the published evidence both in the UK and beyond, this paper also includes case studies from individual carers and examples of interventions designed to strengthen relationships between patients, carers and professionals.

The findings from the study were shared with experts in policy, practitioners, researchers and voluntary sector campaigners at the Sir Roger Bannister Health Summit at Leeds Castle in November 2011.