title: Continuity of care in day surgical care - perspective of patients.
abstract: BACKGROUND
  The realisation of continuity in day surgical care is analysed in this study. The term 'continuity of care' is used to refer to healthcare processes that take place in time (time flow) and require coordination (coordination flow), rapport (caring relationship flow) and information (information flow). Patients undergoing laparoscopic cholecystectomy or inguinal hernia day surgery are ideal candidates for studying the continuity of care, as the diseases are very common and the treatment protocol is mainly the same in different institutions, in addition to which the procedure is elective and most patients have a predictable clinical course.
  
  
  OBJECTIVE
  The aim of the study was to describe, from the day surgery patients' own perspective, how continuity of care was realised at different phases of the treatment, prior to the day of surgery, on the day of surgery and after it.
  
  
  METHODS
  The study population consisted of 203 day surgical patients 10/2009-12/2010 (N = 350, response rate 58%). A questionnaire was developed for this study.
  
  
  RESULTS
  Based on the results, the continuity of care was well realised as a rule. Continuity is improved by the fact that patients know the nurse who will look after them in the hospital before the day of surgery and have a chance to meet the nurse even after the operation. Meeting the surgeon who performed the operation afterwards also improves patients' perception of continuation of care.
  
  
  CONCLUSIONS
  Continuity of care may be improved by ensuring that the patient meets caring staff prior to the day of operation and after the procedure. An important topic for further research would be how continuation of care is realised in the case of other patient groups (e.g. in internal medicine). On the other hand, realisation of continuation of care should also be studied from the viewpoint of those taking part in patient care in order to find similarities/differences between patients' perceptions and professionals' views. Studying interventions aimed to promote continuity of care, for example in patient guidance, would also be of great importance.
authors.affiliation: University of Turku, Department of Nursing Science, Turku, Finland; University of Tampere, Tampere, Finland.
authors.forename: Tarja
authors.initials: T
authors.lastname: Suominen
authors.forename: Ann-Marie
authors.initials: AM
authors.lastname: Turtiainen
authors.forename: Pauli
authors.initials: P
authors.lastname: Puukka
authors.forename: Helena
authors.initials: H
authors.lastname: Leino-Kilpi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures; D003266:Continuity of Patient Care; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
keywords: continuity of care; day surgery; day surgical care; patient perspectives