title: Gaps, disconnections, and discontinuities--the role of information exchange in the delivery of quality long-term care.
abstract: OBJECTIVE
  The smart use of information and communication technologies (ICT) is widely seen as a means of enhancing the quality of aged care services. One of the barriers to ICT diffusion in aged care is the failure to cater for the complex and interdisciplinary requirements of the aged care environment. The aim of this qualitative study was to identify the layers of information exchange and communication and produce a conceptual model that can help to inform decisions related to the design, implementation, and sustainability of ICT.
  
  
  METHODS
  A qualitative study conducted in 2010 within seven Australian residential aged care facilities. It included 11 focus groups involving 47 staff and 54 individual interviews and observation sessions.
  
  
  RESULTS
  The analysis of work processes identified key information exchange components related to the type of information (residential, clinical, and administrative) that is collected, stored, and communicated. This information relies on a diverse number of internal and external communication channels that are important for the organization of care.
  
  
  CONCLUSIONS
  The findings highlight potential areas of communication dysfunction as a consequence of structural holes, fragmentation, or disconnections that can adversely affect the continuity and coordination of care, its safety, and quality.
authors.affiliation: Address correspondence to Andrew Georgiou, Centre for Health Systems & Safety Research, University of New South Wales, Australian Institute of Health Innovation, Level 1, AGSM Building, Sydney, New South Wales 2052, Australia. E-mail: a.georgiou@unsw.edu.au.
authors.forename: Andrew
authors.initials: A
authors.lastname: Georgiou
authors.forename: Anne
authors.initials: A
authors.lastname: Marks
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Braithwaite
authors.forename: Johanna Irene
authors.initials: JI
authors.lastname: Westbrook
mesh_terms: D001315:Australia; D003142:Communication; D003266:Continuity of Patient Care / Q000592:standards*; D017144:Focus Groups; D006707:Homes for the Aged / Q000458:organization & administration / Q000592:standards*; D006801:Humans; D008134:Long-Term Care / Q000458:organization & administration / Q000592:standards; D008490:Medical Informatics; D009735:Nursing Homes / Q000458:organization & administration / Q000592:standards*; D009934:Organization and Administration; D010347:Patient Care Planning / Q000592:standards; D036301:Qualitative Research; D011787:Quality of Health Care
keywords: Communications; Evaluation; Health informatics; Information communication technologies; Organizational communication