Care that ran smoothly, was responsive to clients' needs, and required no special effort for clients to maintain was important for continuity in home care.

et al. What is important to continuity in home care? Perspectives of key stakeholders. Q What are key stakeholders' (clients, caregivers, case managers, and home care workers) perspectives of continuity in home care? DESIGN Qualitative study. PARTICIPANTS 13 case managers, 19 home service providers, 25 clients, 5 caregivers, and 3 physicians who had patients receiving home care. All participants were linked to a community care access centre. METHODS Data were collected mainly by indepth telephone interviews, although some interviews were done face to face. Interviews lasted 45–90 minutes. All but 3 interviews were tape recorded and transcribed (interviews not tape recorded were recorded by hand written notes and dictation after the interviews). An iterative process of data collection and analysis was used to confirm and reconfirm emerging themes. 4 researchers read text associated with various codes and triangulated their interpretations to develop higher level meaning. Data were analysed using a coding scheme derived from preliminary analysis. Input from an advisory group was sought to ensure accuracy of the findings. Continuity of care was experienced as care that ran smoothly, was responsive to clients' needs, and required no special effort for clients to maintain. 2 dimensions of care emerged as important to facilitating continuity. Managing care referred to the importance of care planning, monitoring, and regular review by service providers and case managers, and the importance of care coordination (ensuring the care process was managed, and development and communication of the care plan and care delivery process). Service provision highlighted the importance of continuous service delivery and prevention of interrupted service; consistent, appropriate knowledge and skills (ie, knowledge of the client, the care required, and the home); ongoing, accurate observation by providers so that changes in a client's condition would be monitored; trusting relationships between service providers and clients and caregivers; rapport among care team members to ensure positive and effective working relationships; and consistent timing of care for each day. Communication and consistent personnel support were important to providing continuity in home care. Clients emphasised consistency of timing of service delivery as important attributes for providing continuity of care, and service providers and case managers emphasised care management issues (eg, care planning, monitoring, and coordination). Service providers and case managers identified several groups of clients requiring high levels of continuity of care (ie, people with chronic health problems that involve physical, mental health, or cognitive disabilities; people in the terminal …