The goal of the continuity of care function is to define, shape, and sequence the following processes and activities to maximize coordination of care within this continuum of care.
Patients have access to the appropriate type of care.
When the hospital accepts a patient for entry into a particular service or setting, its decision to do so is based on the outcomes of its assessment procedures. Patients and families receive information about proposed care during the entry process. The hospital ensures continuity over time among the phases of service to a patient. The hospital ensures coordination among the health professionals and services or settings involved in a patient's care. The hospital provides for referral, transfer, or discharge of the patient to another level of care, health professional, or setting, based on the patient's assessed needs and the hospital's capacity to provide the care.