Promoting Continuity of Care During End-of-Life in Bangkok: An Action Research Study.

Continuity of care prioritizes patient-centered approaches. Effective continuity of care is essential for ensuring high-quality service delivery and benefits for patients in the end-of-life phase. Although continuity of care has been well-established, few studies have focused on promoting continuity of care in big cities. The purpose of this action research was to develop a model for continuity of care during the end-of-life phase in Bangkok. Key participants were 8 nurses involved in continuity of care services. The data collection consisted of in-depth interviews, focus group discussions, observation, and document reviews. The research process followed the action research cycle. Content analysis was employed. The 3 emerging domains of continuity of care during the end-of-life included (1) comprehensive patient information; (2) collaborative care management; and (3) technology-supported care. The participants indicated that the key factors to successful continuity of care during the end-of-life involved: (1) clear goals; (2) effective communication; (3) proactive coordination; and (4) good health care provider-client relationships. The model motivated nurses and other providers in the hospital to change practices associated with continuity of care for palliative care patients. This study's findings provide a foundation for future research to strengthen sustainable care continuity and develop palliative care networks in urban Thailand.