title: [Continuous care chain].
abstract: Experiences of a liason nurse work between a hospital and home health care in the Central health centre of Helsinki. Home health care consists almost solely of nursing of elderly people. Today it issues new challenges concerning how the services can meet the elderly people's needs and expectations as good as possible and how these services are coordinated to other social and health services for the elderly. The care of elderly people is focused too much on institutions, but an effort is made to change this by a service structure change. Its aim is to decrease the amount of hospital beds for chronic patients by simultaneously increasing out-patient care. The liason nurse pilot programme is aimed at supporting this structural change by developing discharge of patients and by simultaneously creating more individual and good-quality home health care services.
authors.forename: I
authors.initials: I
authors.lastname: Outinen
authors.forename: L
authors.initials: L
authors.lastname: Pohjakallio
mesh_terms: D000368:Aged; D003152:Community Health Nursing; D003266:Continuity of Patient Care; D005387:Finland; D005851:Geriatric Nursing; D006299:Health Services for the Aged / Q000592:standards; D006699:Home Care Services / Q000592:standards; D006801:Humans; D010351:Patient Discharge