Quality Issues

The State of Care Continuity and Coordination in Acute Care Hospitals
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Introduction
It is the responsibility of an individual to ensure that his or her health status remains in a good shape. This is mostly the case, especially with the emergence of several illnesses that most people suffer from, most of which are acute and require proper and regular medical attention. Cooperation between the client and the doctor is crucial in making such a process a success. This calls for care continuity that depicts the process by which a patient and the health care provider are involved in an ongoing health care management. The process of care continuity ensures that goals of cost effective medical care that is of high quality are maintained. It should be noted that adequate continuity of care is a vital objective of family medicine that is geared towards achieving quality and consistence care to a patient. In addition, it is one of the ways through which a health care giver can win the patient’s confidence, hence, helping him or her disclose all sort of health issues at hand.
It is also one o f the ways through which the physician is placed in a position to play the advisory role on financial issues concerning a patient’s treatment. With the help from other health professionals, the health care provider ensures early diagnosis of a problem that if not given immediate attention would lead to costly medical treatment in future. Continuity of care includes many aspects of care to various categories of patients. However, continuity care consists of a long term patient-physician relationship, and is an approach to health that is based on a team of health care professionals (Woolf, et al, 1999).The discussion in this paper shall be based on trends in palliative care to dying patients in acute care hospitals. Generally, the paper shall begin with a brief analysis of acute care hospitals, in relations to provision of palliative care to dying patients irrespective of the illness. The study shall be based on acute care hospitals based in Canada. Finally, the paper shall give recommendations to challenges identified.
Researchers have established that in most developed countries, with Canada being one of them, more than half of deaths take place in hospitals. Nurses play a crucial role in taking care of dying patients, especially those with acute illnesses. It was recognized that among all the professional health care providers, nurses are charged with the responsibility of ensuring decent deaths to such patients. Nurses are also charged with provision of high quality hands on care to patients, whereas nurses in management are also charged with ensuring consistent and high quality palliative care (Canadian Cancer Society, 2010). Currently, it has also been noted with a lot of concern that most patients seeking palliative care are those suffering from cancer. This could be attributed to changes in the lifestyle, a factor that has contributed to an alarming rate in the increment of infections among Canadians. However, implementation of current health care systems in conjunction to other health changes could have resulted to positive impacts to care provided to dying patients in hospitals (Baker & Norton, et al. 2004). However, this has not been the case as other inefficient systems and practices have bee initiated, hence yielding unfavorable results. For instance, these hospitals have currently shifted from inpatient based to outpatient care, hence raising concerns on issues relating to acute inpatient episodes. It is as a result of implementation of this system that has led to shorter and an increment of inpatient episodes; therefore, hindering the recognition of patients who need palliative care during these critical times. Researchers have also disclosed that those patients who chose to die in hospitals have more needs not met to their satisfaction before death. It is as a result of these allegations that a careful evaluation and comprehension of palliative care needs and practices in hospital is needed for quality assurance and implementation of improvements (Kelly, 2007).
It has been noted that most deaths in Canada occur in among people in advanced old age. This is the case due to decline in health status of an individual due to chronic illnesses that are incurable. This can also be attributed to declining state of health care services, although only a small number of deaths can be attributed to accidents and catastrophic illnesses. In addition, such small number of deaths is considered insignificant, hence providing fewer opportunities when it comes to initiating plans to enable palliative care that ensures good and decent deaths. With current researches carried out, researchers have heavily focused on relevant care to ensure good death (Baker & Norton, et al. 2004). Among these studies, most of them focus on factors that determine or contribute good deaths. However, there have also been concerns on the extensive use of technologies that prolong life and treatment in acute care hospitals. It can be argued that such is not an ethical practice since provision of care services that could extend life could be contradictory to needs of a terminally ill or a dying patient (Kelly, 2007).
With the palliative care in a patient, it should also incorporate aspects of end of life care at the same time. This is crucial as it psychologically prepares a patient for the ultimate fate that is death. For instance, a cancer patient, with proper consultations, should identify an appropriate hospital from where he or she can seek medication. With the existence of a good partnership between the patient and the doctor, the doctor should be in a position to advise this patient on how to prepare for his or her death. In hospitals, there exist different categories of individuals that require end of life care. There are various factors that nurses should consider in determination of the type of end of life care to render a patient (Kelly, 2007). For instance, age, type of illness, sex, marital status and place of the patient’s residence should be put into consideration. Studies carried out also revealed that most t...