Information |
The quality of information that is exchanged between care settings in terms of completeness, accuracy and clarity. |
Medication reconciliation by a hospital pharmacist, study pharmacist, liaison pharmacist or community pharmacist; electronic templates as the main method of information sharing; database-generated discharge summaries comprising structured formats to organize information; clinical decision support, alerts for pending results and online reference information. |
Coordination of care |
The quality of assessment, planning, and organization of follow-up services and needs. |
Organizing post-discharge services or follow-up; a discharge planning protocol; early assessment of follow-up needs and resources; general practitioner input into discharge planning; post-discharge check for follow-up needs, adjustments and arrangements. |
Communication |
The quality of exchanging information in terms of personal and direct contact, accessibility, and timeliness. |
The use of a liaison pharmacist or nurse; use of a fax or e-mail to transmit discharge summaries, plans and other relevant information in a timely manner; electronic notifications to inform GPs about patient hospital visits and available discharge information; telephone outreach from hospital to home care to notify the primary contact for follow-up consultation; face-to-face meetings in community or hospital; case conferences by telephone. |