Coherence and Breadth of Consideration.

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Coherence and Comprehensiveness of Care

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What is Continuity of Care? Conventional Family Doctor: = single supplier and single patient in a longitudinal, individual relationship Mental Health Worker: = coordination of numerous administrations after some time. Normal arrangements and objectives.. numerous suppliers Nurse: = smooth data exchange Diabetic center: = "continuum of consideration", different suppliers, convention and result driven

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Can we characterize Continuity of Care in connection of: … .. Specialist : ie " Dr X dependably cares for the majority of my issues in an opportune manner" Patient : ie "Tolerant X dependably has her issues took care of in a convenient manner by a gathering of suppliers"

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Doctor/quiet relationship is vital BUT… . Are we QUARTERBACKS Or ORCHESTRA CONDUCTORS What about PROVIDER/persistent connections in a multidisciplinary group model ?

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3 sorts of Continuity Informational Management Relational

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Why return to Continuity of Care? Ailment Complexity Determinants of Health Chronic Disease Burden Increased spotlight on showing Increased spotlight on Multidisciplinary care Access issues How would we convey day in and day out Marcus Whelby is dead

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Saint John CHC Greater Saint John access: 80 Family Doctors 125,000 nationals 140,000 ER visits p.a. 140,000 FD/stroll in visits CHC catchment access 12 Family specialists 35,000 natives

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CHC 5 Family specialists, 4 Nurse Practitioners 3 LPN 2 dieticians 1 Social laborer And a… … ..

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CHC OT , Domestic Violence Worker, Teen Resource laborers Numerous effort specialists and projects Base patient number : 9000 Chronic Disease Clinics, Mental Health, Teen Clinic, Outreach to Sal Army, Soup Kitchens, Homeless and so forth and so on Medical administrations: Prenatal/Antenatal, Palliative Care ,Hospital Care , Shared Mental Health , Minor Surgeries , House calls and so on, and so on Vital associations with group offices

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How would you be able to have Continuity of Care in such a model???? Data Technology (educational congruity of consideration) Multidisciplinary Teams (administrative coherence) Every patient has an essential supplier and MD/NP group( social progression)

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Issues being developed of new Continuity of consideration Models Change Management Government Expectations Evaluation models… .Audits … result based … ..persistent fulfillment… . Issue: What do we contrast it with? Advertising Co area Realistic numbers and desires "Wear Quixote" disorder "say no to secure your yeses"

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Lessons Learned Need Community Needs Assessment (not simply rehearse needs appraisal) Triage Navigation Patients need to think about educational progression Marketing Linked arrangements Time asset administration Some patients incline toward old model .They ought to have choices accessible

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