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Evidence to Improve Care

Palliative Care

Care for Adults With a Serious Illness


10

Transitions in Care

People with identified palliative care needs experience seamless transitions in care that are coordinated effectively among settings and health care providers.


Transitions in care that are based on patient needs involve logistical arrangements to move a person from one care setting to another or from one care provider to another. To ensure continuity of care, transitions in care should be coordinated among knowledgeable and skilled health care professionals who are familiar with the person’s clinical status, goals of care, plan of treatment, care plan, and health information needs.

Timely and effective communication is essential to prevent problems that may occur if services and supports are not well integrated (e.g., delayed transfers, readmissions, or poor care). Identifying a member of the care team to be accountable for care coordination supports a smooth transition between settings and prevents communication failures. Information-sharing between settings to ensure all health care providers are aware of the person’s current condition is part of effective and coordinated communication. All information-sharing during care transitions must consider legislated privacy and security requirements.

Families and caregivers also play a vital role in transitions. Health care professionals should have informed discussions with them about available care settings. Health care professionals should work together, and with the patient, their family and their caregivers, to ensure that transitions in care are timely, appropriate, and safe.

For Patients, Families, and Caregivers

When you change care settings or care providers (for example, if you return home after being in hospital), your care team should work with you to make sure you and any new team members have the right information (such as information about your medication). They should also make sure you receive the services you need (such as plans for follow up).


For Clinicians

Ensure that people moving between care settings or care providers experience coordinated and seamless transitions. This includes facilitating communication between settings and other related processes.


For Health Services

Ensure that systems, processes, and resources are in place to facilitate communication and information-sharing between care providers and care settings during transitions.

Process Indicator

Percentage of people who receive palliative care whose medical record identifies the member of the care team responsible for care coordination

  • Denominator: total number of people who receive palliative care

  • Numerator: number of people in the denominator whose medical record identifies the member of care team responsible for care coordination

  • Data source: local data collection


Outcome Indicator

Percentage of people who receive palliative care (or their caregivers) who state that they experienced seamless transitions between care settings

  • Denominator: total number of people who receive palliative care (or their caregivers)

  • Numerator: number of people in the denominator who state that they experienced seamless transitions between care settings

  • Data source: local data collection

  • Similar question available in the CaregiverVoice Survey: “To what extent did he/she experience smooth transitions between all settings of care during the last 3 months of life?” (Response options: “Always, Most of the time, Sometimes, Rarely, Never, Don’t know”) 

Seamless transition

A seamless transition consists of a set of actions designed to ensure the safe and effective coordination and continuity of care when patients experience a change in health status, health care professional, or location (within, between, or across settings).


Coordinated effectively

Coordinated care is the deliberate organization of patient care activities between two or more participants involved in a patient's care (including the patient) to facilitate the appropriate delivery of health care services. Organizing care involves coordinating people and resources to carry out required patient care activities and is often managed by exchanging information among those responsible for the various aspects of a patient’s care.

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