Centre for Care Research, Gjøvik University College, Gjøvik, Norway.
J Nurs Manag. 2013 Jan;21(1):182-90. doi: 10.1111/j.1365-2834.2012.01366.x. Epub 2012 Mar 30.
To explore continuity of care from a manager's perspective: How do managers understand the concept of continuity of care and how do they assess continuity of care in home health-care? How do managers work to ensure continuity of care when managing care provision for patients in their homes?
Continuity of care is considered a prerequisite for service quality. Managers can influence continuity of care through managing day-to-day work.
Semi-structured interviews of a purposive sample of 16 managers from 12 municipal units. Theory-driven and data-driven analysis was applied.
Ideally, to promote continuity of care, the number of carers should be limited. Yet, in practice, discontinuity of care was accepted as a working compromise. The managers faced two paradoxes: the continuity ideal vs. the practicalities of home health-care, and caring for patients vs. caring for staff.
The managers were forced to prioritize, in conflict with ideals or professional standards, patients' wellbeing or the wellbeing of the staff. Ensuring continuity of care for all patients did not seem feasible.
The study highlights management paradoxes: possible unintended consequences of prioritizing needs for continuity of care should be objects of reflection in care management.
从管理者的角度探讨延续护理：管理者如何理解延续护理的概念，以及他们如何评估家庭保健中的延续护理？管理者在管理患者家中的护理服务提供时，如何努力确保延续护理？
延续护理被认为是服务质量的前提。管理者可以通过管理日常工作来影响延续护理。
对来自 12 个市立单位的 16 名管理者进行了有针对性的半结构式访谈。应用了理论驱动和数据驱动的分析方法。
理想情况下，为了促进延续护理，护理人员的数量应该有限。然而，在实践中，间断性护理被接受为一种工作上的妥协。管理者面临着两个悖论：延续性理想与家庭保健的实际情况之间的矛盾，以及照顾患者与照顾员工之间的矛盾。
管理者被迫优先考虑，这与理想或专业标准相冲突，是患者的福祉还是员工的福祉。似乎不可能为所有患者提供持续的护理。
本研究强调了管理悖论：在护理管理中，应将优先考虑延续护理需求的可能意外后果作为反思的对象。
