Other Challenges to Continuity
Continuity & Comprehensiveness of Care
Primary Care Toolkit for Family Physicians
The College of Family Physicians of Canada
Hospital or Other Institutional Care
Recognizing the efficiencies that can be derived from hospital call groups responsible for the care of in-patients, many family physicians are now changing the way they provide hospital care. For example, an alternative for in-patient coverage includes establishing care teams in which each family physician takes responsibility for a limited number of in-patients on a rotational basis. Other examples include obstetrical call groups of family physicians to ensure the ongoing availability of a family physician at all times for intrapartum care. In some models, the special knowledge and skills of family physicians are recognized within their call group, allowing the group to provide more comprehensive care to patients with special needs, (e.g. psychotherapy or palliative care for patients in hospitals or institutions).
The impact of out-patient or ambulatory clinics attached to hospitals must also be considered when trying to ensure continuity and comprehensiveness of care, (e.g. clinics providing services in oncology, palliative care, eating disorders and crisis or sexual counseling). Assuming the family practice or primary care group cannot provide all services, communication between external clinics and family physicians is essential for good care.