Figure 1
Haggerty’s continuity of care framework.
Figure 2
The impact of complexity, multiple morbidities and cognitive impairment on care continuity.
Table 1.
Breakdown of care providers interviewed by role and care setting in which they practice
| Acute care | Inpatient rehabilitation | Long-term care and retirement home | Home care delivery coordination |
| • Director • Clinical manager • Two resource nurses • Community care access centre case manager* | • Clinical manager • Physiotherapist • Occupational therapist • Resource nurse • Community care access centre case manager* | • Director of long-term care • Director of retirement home • Kinesiologist • Resource nurse | • Senior director • Two community care case managers* |
Table 2.
Participant codes, roles and care setting
| Participant code | Care setting | Role |
| FP12 | In-patient rehabilitation | Nurse practitioner |
| FP13 | In-patient rehabilitation | Physiotherapist |
| FP14 | In-patient rehabilitation | Occupational therapist |
| FP15 | In-patient rehabilitation | Resource nurse |
| FP21 | In-patient rehabilitation | Nurse manager |
| FP22 | In-patient rehabilitation | Nurse case manager |
| AC1 | Acute care | Nurse |
| AC2 | Acute care | Nurse manager |
| AC5 | Acute care | Nurse case manager |
| AC6 | Acute care | Resource nurse |
| RH1 | Retirement home | Nurse manager |
| LTC2 | Long-term care | Nurse manager |
| HC1 | Home care coordination | Nurse case manager |