Continuity of information and care : a pilot study in a health centre

Abstract

Introduction: Family medicine is the first level of contact of individuals, the family and the community with the national health.1 Quality of continuity is the degree of which a series of discrete encounters with health care professionals is coherent, connected, and consistent with the patient's medical needs and personal context.2 Objective: The aim of this study was to assess continuity of care in patients attending for General Practitioner consultations in Floriana Health Centre (FHC). Method: The study focused on all the physician- patient encounters occurring in the GP consultation rooms between 8 a.m. and 5 p.m, which accounts for the overall majority of patient contacts in health centres over a 24 hour period. This was a pilot study and consequently the study was carried out in only one health centre. The field work was carried out on five working days, including a Sunday. The number of medical records which were given to patients was noted together with the total number of patients attending for a consultation. This data was then divided in morning (8a.m. – noon) and afternoon (noon – 5p.m) sessions. Medical records given to GPs were assessed to see whether an entry was actually made and the quality of the entry. Results: A total of 529 patient encounters were included in the study. There were 411 patients attending the FHC for a GP consultation between 8a.m. and 5p.m. in four weekdays and 118 patients attending a consultation on Sunday. 23% of patients attending for a GP consultation during weekdays were given a file while 77% were not. A higher percentage of medical records were not given in the afternoons. 75% of GPs wrote a note in the patient’s file when it was provided to them. Conclusion: Continuity of care is an important and essential element in delivering good quality healthcare service to the patient. Continuity of care is not occurring to the desired degree in FHC and is possibly leading to sub-optimal care being provided to our patients. The intention is that in the future, this pilot study will be implemented on a larger scale in other health centres for a greater representation of the work being done at primary care level.