Caring for People with Acute Conditions: Transitional Care, Relocation of Care and New Division of Work

There is an overall trend towards decreasing length of stay in hospitals. Earlier discharges and transitions to home and community care are increasing, as well as the use of outpatient clinics for acute care across European countries. How this is implemented varies significantly not only between but also within countries (Corbella et al., 2018).

Earlier discharge and shorter hospital stays result in more patients with more complex conditions being treated in the community by health professionals in primary care and in specialized ambulatory care settings.

Ineffective care transitions resulting from poor cross-site communication and collaboration can lead to suboptimal patient outcomes. Key factors fostering more effective care transitions include interdisciplinary coordination and collaboration of patient care across care sectors, shared accountability by all clinicians involved, provision of appropriate support and follow up after discharge (Reference Sheikh, Gathecha and BellantoniSheikh et al., 2018), mutual respect, shared goals and good communication. New models of care easing the shift in the location of care use existing health professionals in new ways (for example, extended roles) or introduce new professionals (for example, physician assistants or retinal screeners). These changes reflect an ongoing and dynamic process.

We focus this chapter on the changing skill-mix of health professionals providing care for patients with acute illnesses.