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Archived Comments for: Development of a patient-centred care pathway across healthcare providers: a qualitative study

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  1. Perspective is crucial

    Ellen Schultz, Stanford University

    10 May 2013

    This article highlights the critical importance of considering perspective when addressing care planning and care coordination. From a distance, all the clinicians who participated in this study might be considered to represent the same perspective--that of health care professionals from within the same health care system--yet as so clearly demonstrated through the experience of this study, they are very much not "on the same page." The disconnect between those participants from the primary care setting who were oriented towards patients and supportive care needs and the participants from the hospital setting who were oriented towards particular diseases underscores the depth of fragmentation--cultural as well as structural--in this particular health system. Experience suggests that this cultural divide is not unique to this particular study sample. It also suggests that here, and in many other systems that likewise struggle to coordinate care, simply transferring information is unlikely to be sufficient for achieving coordination. If care is to be effectively coordinated across settings, all the providers from those various settings must be able to understand the goals, orientation and approaches of one another. A common understanding would allow these different perspectives to reinforce one another, becoming a system strength rather than an obstacle to coordinated care. For indeed, both a broader, holistic concern for patients' well-being and a narrow focus on the details of specific health conditions are important in providing comprehensive, high-quality care. We have much work to do to achieve such a common understanding. Bringing together providers from different parts of a health system, as described here, is an instructive start. Let's hope it's just the beginning.

    Competing interests