The role of documentation and inter-provider information exchange in care continuity for older hip fracture patients.

Maintaining continuity of patient care can be difficult during transitions between care settings, when quality of care and patient safety are at risk. We sought to understand the role of inter-provider documentation and information exchange across successive care settings for complex, older patients. Data were gathered as part of a multi-site ethnographic study that followed 23 older post-surgical hip fracture patients across multiple care transitions. Documentation and information exchange help build a "picture" of complex patients, but care continuity is challenged by late, missing or unnecessary information, duplicated assessments and lack of interoperability of electronic systems. This study demonstrates the importance of appropriate documentation in the transition process, but points to the need for comprehensive system-level solutions which standardize information collection and sharing along the continuum of care.