Moving home or going into hospital are times when a consumer most needs to be in touch with someone they know, yet this is often the signal for their current key worker arrangements to terminate and their case to be transferred. In addition, this can sometimes take some while to occur during which time the consumer is in an unsupported organisational limbo when things can go wrong. For example, it is still the practice in some places that admission for acute inpatient care is an event which disrupts previous community arrangements, interrupting continuity. The admission might be handled by an emergency team whose personnel may not be known to the consumer. As soon as the consumer is hospitalised, they cease to have a community-based key worker.
Discontinuity also arises when consumers move home.
It becomes the hospital's responsibility to discharge the person and a new key worker is appointed by the community team, often a long time after discharge. The key worker is most valuable in assisting admission when it is needed, staying in touch, and making arrangements to ensure that discharge is well planned. Key workers should really stay in touch with their consumers until satisfied that their consumers are in contact with their successor, ie, the case is handed on rather than leaving the consumer waiting until something or someone turns up. Access This is usually shorthand for 'assistance in crisis' or 'impending crisis'. Crisis may be occasioned by recurrence of an illness or some social event producing unmanageable stress, eg, the telephone being cut off, etc Good key workers help consumers to prepare their personal 'crisis drills' for such occasions and to anticipate problems whenever possible.