Understanding care work and the coordination of care process conglomerations

Abstract

Health and social care is becoming ever more complex as a consequence of societal trends, including an aging population and increased reliance on care at home. One aspect of the increased complexity is that a single patient may receive care from several care providers, which easily results in situations with potentially incoherent, uncoordinated, and interfering care processes. In order to describe and analyze such situations, the article introduces the notions of patient-centered care process and a conglomeration of such. The latter is defined as a set of patient care processes that all concern the same patient, are overlapping in time, and are all sharing the overall goal of improving or maintaining the health and social well-being of the patient. The processes are based on a PDCA-cycle comprising phases for assessing, planning, performing and following up the care for the patient independently of health and social care organizations.