Development and evaluation of a Continuity of Care Checklist for improving orthopaedic patient discharge from hospital

Abstract

In this study, we developed and evaluated a Continuity of Care Checklist (CCC) to assist nurses in comprehensively reviewing practices related to continuity of care for orthopaedic patients discharged from hospital to community. The CCC was designed to ensure nurses would attend to multiple dimensions of continuity including informational continuity, relational continuity and management continuity. To evaluate the CCC, patients discharged from an orthopaedic unit (n = 77) were interviewed about continuity of care. The CCC was then implemented and a second group of patients (n = 77) was interviewed to examine changes in care. Structured interviews were also conducted with nurses (n = 12) to learn about their experiences with the CCC. Interviews with patients revealed significant improvements in patient perceptions of information provision, involvement of informal caregivers in discharge, communication between hospital and community providers, consistency of information, and satisfaction with patient–provider relationships. Nurses who used the CCC found the tool improved standards for care and patient involvement in care. The CCC appears to be a practical tool for assisting nurses in systematically improving continuity of care among orthopaedic patients. Future directions for research and practice using the CCC are described.