Continuity of care for older adults in a Canadian long-term care setting: a qualitative study

Madeline King; Carolyn Steele Gray; Daniel Kobewka; Agnes Grudniewicz

doi:10.1186/s12913-022-08583-1

Continuity of care for older adults in a Canadian long-term care setting: a qualitative study

BMC Health Serv Res. 2022 Sep 27;22(1):1204. doi: 10.1186/s12913-022-08583-1.

Authors

Madeline King¹, Carolyn Steele Gray^{2

3}, Daniel Kobewka^{4

5}, Agnes Grudniewicz⁶

Affiliations

¹ Telfer School of Management, University of Ottawa, 55 Laurier Avenue East, Ottawa, ON, K1N 6N5, Canada.
² Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Heath, 1 Bridgepoint Drive, Toronto, ON, M4M 2B5, Canada.
³ Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M6, Canada.
⁴ Clinical Epidemiology Program, Ottawa Hospital Research Institute, 1053 Carling Avenue, Ottawa, ON, K1Y 4E9, Canada.
⁵ Department of Medicine, The Ottawa Hospital and University of Ottawa, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada.
⁶ Telfer School of Management, University of Ottawa, 55 Laurier Avenue East, Ottawa, ON, K1N 6N5, Canada. grudniewicz@telfer.uottawa.ca.

Abstract

Background: Continuity of care has been shown to improve health outcomes and increase patient satisfaction. Goal-oriented care, a person-centered approach to care, has the potential to positively impact continuity of care. This study sought to examine how a goal-oriented approach impacts continuity of care in a long-term care setting.

Methods: Using a case study approach, we examined what aspects of goal-oriented care facilitate or inhibit continuity of care from the perspectives of administrators, care providers, and residents in a long-term care centre in Ontario, Canada. Data was collected through documentary evidence and semi-structured interviews.

Results: We analyzed six internal documents (e.g., strategic plan, client information package, staff presentations, evaluation framework, program logic model), and conducted 13 interviews. The findings indicated that the care provided through the goal-oriented approach program had elements that both facilitated and inhibited continuity of care. These factors are outlined according to the three types of continuity, including aspects of the program that influence informational, relational, and management continuity.

Conclusions: Aspects of the goal-oriented care approach that facilitate continuity can be targeted when designing person-centered care approaches. More research is needed on goal-oriented care approaches that have been implemented in other long-term care settings to determine if the factors identified here as influencing continuity are confirmed.

Keywords: Continuity of care; Goal-oriented care; Long-term care; Older adults; Person-centered care.

MeSH terms

Aged
Continuity of Patient Care
Humans
Long-Term Care*
Ontario
Patient Satisfaction*
Qualitative Research