No doubt there will be reports of rehospitalization and serious complications such as pulmonary embolism or wound infection, but we must look at the whole picture and consider that such complications can still happen when the patient stays an extra 2 or 3 days in hospital. Nevertheless we must prepare ourselves because the caremap process requires extensive homework by the treating physician, outpatient and inpatient nurses and the home caregiver. The home-care component is crucial for the success of the whole process. If it is not in place at the appropriate time, its acceptance by the public could be negatively affected, with catastrophic results. The delivery of home care should be closely monitored, and there should be proper liaison with the hospital team to ensure continuity of care and effective feedback to the treating physician.
Patient education is of prime importance in the implementation of a caremap program.
Patients should be well informed and share in the choice of their treatment. A recent study by the Canadian Prostate Health Council1 demonstrated that patients participating in a shared decision for choices of treatment were better informed and had a better rapport with their physicians than those who did not. Patients should know that they are not being abandoned by the hospital or discharged prematurely but that at a certain stage their management is better given by the home-care team in close association with the hospital team. They should be reassured constantly that this protocol is better for them, that they will be more comfortable and that the hospital team is always available. It is only with such a new contractual agreement that the whole process of caremap management can achieve its required goals.