Overview of Care Coordination Within Specialized Home Care in Stockholm County

Abstract: The ageing population of Sweden is expected to increase throughout the future decades. Changing life-style trends and smaller families in the modern society has decreased the population’s access to informal care. This is expected to entail an increase in the services provided by specialized home care. This thesis studies the work performed by nurses within the department of specialized home care (ASIH) in Stockholm County. The nurses represent the majority of all professions active at ASIH in Stockholm County, which puts their work in particular interest for this thesis. The thesis focuses on the ways the nurses’ work procedures may influence continuity of care and patient safety. Continuity of care is an essential component in qualitative care and is characterized by well-executed coordination and minimization of broken patient appointments. A high level of continuity of care consequently entails a high level of patient safety. Descriptions of continuity of care at ASIH in Stockholm County can therefore provide indications on current care quality and areas of improvement. The thesis consists of two parts – a literature review containing international research on continuity within home care and an empirical study containing a retrospective analysis based on the Functional Resonance Analysis Method (FRAM). The empirical study creates an overview of work tasks related to nursing performed at three units of ASIH in Stockholm County. The interdependencies between work tasks are identified and important chain reactions are analyzed. The findings from this thesis indicate that extended training programs for nurses in the initial phase of employment is likely to decrease the number of disruptions in the nurses’ work. Furthermore, well-developed routines could facilitate work task procedures which would decrease the number of delays and disruptions in the nurses’ work. It was found that these findings together with information continuity between all parties involved represent significant factors for attaining continuity of care and patient safety at ASIH in Stockholm County.