Cross-continuum Care Continuity: Achieving Seamless Care and Managing Comorbidities

J Nurs Adm. 2017 Jul/Aug;47(7-8):399-403. doi: 10.1097/NNA.0000000000000503.

Abstract

As healthcare systems continue to design care models responsive to payment changes and the assumption of clinical and financial risk, the need exists for a comprehensive approach to address cross-continuum care transitions. This article will highlight key learnings from the Nurse Executive Center's research on achieving care continuity. The business case for developing a cross-continuum care transition strategy will be discussed, as well as systemic enablers for the achievement of seamless care. A case study example of 1 system's solution for supporting the multiple comorbid patient population as part of its cross-continuum care transition strategy will be examined.

MeSH terms

  • Adult
  • Comorbidity*
  • Continuity of Patient Care / organization & administration*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nurse Administrators / organization & administration*
  • Nursing Care / organization & administration*
  • Professional Role*
  • Texas