title: [Home medical care network in the community supporting hospital--nursing consultant acting for community coordination].
abstract: Tama Nambu-Chiiki Hospital is a secondary medical institution providing the acute short-term care centered on cancer treatment and emergency medical service, which few other medical institutions in the region provide. The hospital, which has no system to directly support home medical care by house visit or visiting nurses, needs to coordinate home medical care with other community medical institutions. 2 nurses serve as the Nursing Consultants who provide consultation services over the issues related to home medical care and other issues face to face or by phone and coordinate home medical care with other community medical institutions. Medical coordination based on trust and understanding of home medical care by hospital staffs are essential for the smooth transfer to home medical care. Activities of the hospital are studied to cope with the changes in healthcare trend.
authors.affiliation: Community Healthcare Coordination Office, Tama Nambu-Chiiki Hospital.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Ohtsu
authors.forename: Akiko
authors.initials: A
authors.lastname: Shinobu
mesh_terms: D003152:Community Health Nursing; D019058:Community Networks; D003253:Consultants; D006699:Home Care Services; D006764:Hospitals, Community; D006801:Humans; D020380:Needs Assessment; D012944:Social Support