Читать книгу Kelly Vana's Nursing Leadership and Management - Группа авторов - Страница 96

The majority of patient care and health care occurs in communities outside acute care settings. Primary care “which provides integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community” (IOM, 1996, p. 1), should be better understood and appreciated for the role it has in improving patient's health status and health outcomes. The key foundations of primary care (Starfield, 1998) can be applied across the health care continuum and across organizational settings, because primary care emphasizes seven important features: care that is continuous, comprehensive, coordinated, community oriented, family centered, culturally competent, and begun at first contact with the patient. According to Starfield (1998), patients and clinicians need to work together to appropriately utilize services, based on the following four foundations of primary care:

 First Contact: Conduct the initial evaluation and define the health dysfunction, treatment options, and health goals.

 Longitudinality: Sustain a patient–clinician relationship continuously over time, throughout the patient's illness, acute need, and disease management.

 Comprehensiveness: Manage the wide range of health care needs, across health care settings and among different health care professionals.

 Coordination: Build upon longitudinality. Care received through referrals and other providers is followed and integrated, averting unnecessary services and duplication of services.