Family Medicine

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Original abstract World Book of Family Medicine – European Edition 2015 http://www.woncaeurope.org/content/313-wo-educational-change-users-perspective-educational-agenda-gpfm References 1. Council Directive 93/16/EEC to facilitate the free movement of doctors and the mutual recognition of their diplomas, certificates and other evidence of formal qualifications. Official Journal of the European Community. 1993;165:7/7/93. 2. Innes RB. Reconstructing undergraduate education. Using Learning Science to Design Effective Courses. Larence Erlbaum, New Jersey London, 2004. 3. Harris IB. Educating Professionals, Responding to New Expectations for Competence and Accountability. In: “New Expectations for Professional Competence”. Curry L, Wergin JF and ass. Jossey-Bass, 1993. 4. Heyrman,J. ed., EURACT Educational Agenda, European Academy of Teachers in General Practice EURACT, Leuven 2005. 5. Wilm S, ed., Assessment of General Practitioners’ Performance in Daily Practice: The EURACT Performance Agenda of General Practice /Family Medicine (EUPA). Düsseldorf university press, Duseldorf 2014. http://www.euract.eu/officialdocuments/finish/3-official-documents/307-euract-performance-agenda-eupa-2014 6. Allen J, Price E, Svab I, Windak A. Framework for Continuing Educational Development of Trainers in General Practice in Europe (CEDinGP). ZiZ Centrum Edukacji Ltd., Krakow 2012. http://www.euract.eu/official-documents/finish/3-officialdocuments/241-framework-for-continuing-educational-development-of-trainers-in-general-practice-in-europe-cedingp 7. Hummers-Pradier E, et al., Research Agenda for General Practice / Family Medicine and Primary Health Care in Europe, EGPRN, Maastricht 2009 http://www.egprn.org/files/userfiles/file/egprn%20research%20agenda%20summary.pdf 148
World Book of Family Medicine – European Edition 2015 Francesco Carelli francesco.carelli@alice.it 48 – Continuity of Care Francesco Carelli Professor, EURACT Council Executive Board, BME Committee Chair, LJPC International Editor Continuity of care is a cornerstone of family medicine and a key point for patients. It has been included by EURACT (European Academy of Teachers in General Practice and Family Medicine), in “Person-centred care”, and one of the “Core competences of GP/FM”(1), as the ability “to provide longitudinal continuity of care as determined by the needs of the patient, referring to continuing and co-ordinated care management”. It can be interpreted as following the patient from birth (sometimes also before) until death (sometimes even after), throughout their whole life. Continuity of care, also described as ‘the ability to manage in continuity of time, in the individual, a series of multiple complaints and pathologies, both acute and chronic health problems’ (3), enables doctors to promote health and well-being by applying health care and disease prevention strategies appropriately, as described in another core competence, the “Comprehensive Approach”. It is firmly bound to other core competencies, in the “Holistic Approach” (considering a biopsychosocial model taking into account cultural and existential dimensions), and “Community Orientation” (also taking into account the community in which the individual patient lives and trying to reconcile health needs of both individual patient and community in balance with available resources). With continuity of care, it is possible to adequately handle risk factors by promoting self-care and empowering patients. The family doctor knows the community's potential and limitations, health needs, epidemiological characteristics, interrelationships between health and social care, impact of poverty, ethnicity, and inequalities in health care. He also needs to have an understanding of the structure of the health care system, with its economical limitations, the correct use of its services by patient and doctor (referral procedure, co-payments, sick leave, legal issues etc.) in their own context. All this is possible through provision of continuity of care by GP/Family Doctor. The multiple dimensions of continuity Fletcher et al. (3) distinguish between “coordination” as “the degree to which various components of care bear a useful relation to each other”, and “continuity” as “the existence of some thread - individual, practitioner, group, or medical record - that bind together episodes of care”. But the term ‘continuity of care’ has been used to describe a great variety of relationships between patients and the delivery of health care. (4) Record Continuity refers to availability of all the information about a patient's history, visits, tests, allergies, medications, and preferences, in a medical record or clinical database, easily shared by all the clinicians caring for the patient, whether in the same institution, between institutions, or between care settings. This can improve quality of care in the presence of increasing mobility of patients, increasing numbers of people involved in their care, 149
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Family Medicine

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