Abstract
BackgroundNumerous studies have revealed challenges associated with ensuring informational continuity in municipal care services for older adults with comprehensive, prolonged and complex care needs. Most research is qualitative and on the micro-level. The aim of the current study is to map variation in homecare nurses’ assessments of available information in the municipalities’ documentation system and investigate the extent to which these assessments are associated with perceived quality of collaborations and with municipal context.MethodsWe used data from a nationwide web-based survey among 1612 nurses working with older adults (65+) in homecare services in Norway. Responses from individual homecare nurses were linked with municipal-level data from the public registers. Data were analysed with descriptive statistics and multilevel regression analyses.ResultsInformation on the recipients’ medications and medical condition was considered most often available (42.8 and 20.0% responding very often/always), whereas information related to psychosocial needs and future follow-up was perceived less available (4.5 and 6.7% responding very often/always). Homecare nurses’ perceptions of the quality of collaboration with the GP and the allotment office were independently and positively associated with assessments of informational continuity (ß =0.86 and ß =0.96). A modest share of the total variation (8%) in assessments of informational continuity was at the structural level of municipality. Small municipalities (< 5000 inhabitants) had, on average, better informational continuity compared to larger municipalities (ß = -0.47).ConclusionsDocumentation systems have a limited focus on long-term care needs of older care recipients beyond clinical and medical information. There is a potential for enhanced communication- and care-pathways between GPs, the allotment office and nurses in homecare services. This can support the coordinating role of homecare nurses in ensuring informational continuity for older adults with prolonged and complex care needs and help develop the facilitating role of (electronic) documentation systems.
Highlights
Numerous studies have revealed challenges associated with ensuring informational continuity in municipal care services for older adults with comprehensive, prolonged and complex care needs
Documentation systems have a limited focus on long-term care needs of older care recipients beyond clinical and medical information
There is a potential for enhanced communication- and care-pathways between Primary physician/General Practitioner (GP), the allotment office and nurses in homecare services
Summary
Numerous studies have revealed challenges associated with ensuring informational continuity in municipal care services for older adults with comprehensive, prolonged and complex care needs. The availability of patient information to providers throughout the healthcare system is crucial for patient safety and the quality of care services [1]. This applies to older home dwelling adults with comprehensive and prolonged care needs [2]. In these instances, municipal health care services typically involve multiple care encounters over time with visits from more than one, often many, carer(s) [3]. In order to maintain informational continuity, there is a need for systematic (electronic) written as well as oral information exchange between different providers in the municipal care setting, such as the primary physician (GP), the allotment office, persons working in short- and long-term institutional care and in homebased services [7, 11]
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