title: Continuity of rehabilitation services in post-acute care from the ambulatory outpatients' perspective: a qualitative study.
abstract: OBJECTIVE
  To explore ambulatory outpatient experiences and perceptions in post-acute care settings and how these experiences may have led to perceived gaps in continuity of rehabilitation care.
  
  
  METHODS
  Fifty-seven adults undergoing outpatient rehabilitation for musculoskeletal conditions/injuries, who had had more than 10 physiotherapy treatment sessions.
  
  
  METHODS
  Qualitative study using a modified grounded theory approach. Data collection was carried out through 9 focus groups. Each group was recorded, transcribed literally and analyzed thematically.
  
  
  RESULTS
  Participants described 3 main themes in continuity; relational, informational, and management continuity. Several factors that led to gaps in the 3 types of continuity were described. The relevant factors for relational continuity were: consistency of the multi-professional rehabilitation team; and an established provider-patient relationship. Factors for informational continuity were: transfer of information among providers; and accumulated knowledge regarding patients' disability experiences. Factors for management continuity included: consistency of care among rehabilitation providers; flexibility of the team in adapting care to functional changes; and involvement of the team in achieving patient collaboration.
  
  
  CONCLUSIONS
  This study provides evidence of gaps in different types of continuity of care within the post-acute rehabilitation services in ambulatory settings. Outpatients often perceive their experiences of rehabilitation care as non-connected or non-coherent over time.
authors.affiliation: Department of Physiotherapy, University of Murcia, 30100, Murcia, Spain. mirapeix@um.es
authors.forename: Francesc
authors.initials: F
authors.lastname: Medina-Mirapeix
authors.forename: Silvana
authors.initials: S
authors.lastname: Oliveira-Sousa
authors.forename: Marta
authors.initials: M
authors.lastname: Sobral-Ferreira
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Del Baño-Aledo
authors.forename: Pilar
authors.initials: P
authors.lastname: Escolar-Reina
authors.forename: Joaquina
authors.initials: J
authors.lastname: Montilla-Herrador
authors.forename: Sean M
authors.initials: SM
authors.lastname: Collins
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D003266:Continuity of Patient Care; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000534:rehabilitation*; D010045:Outpatients; D017060:Patient Satisfaction; D026741:Physical Therapy Modalities; D011369:Professional-Patient Relations; D011795:Surveys and Questionnaires; D014947:Wounds and Injuries / Q000534:rehabilitation*