Summary
Continuity of care is a complex concept that can be described as patients' experiences of coherent and linked care over time, and is characterized by multiple domains including information flow, patient-provider relationships, and coordination of care (1). Issues of continuity of care should be examined from the perspective of both the client and the provider. Service providers are in a good position to understand the needs and issues related to quality of care and the environment in which the most effective and acceptable interactions can occur (2). As a result of concerns about continuity of care, a new service delivery model in KFL&A Public Health's Early Expressions Speech and Language program was implemented in January 2009. This change was evaluated with respect to both the service provider and the client.
The results of the service provider component of the Early Expressions continuous quality improvement initiative suggest that the change to the service delivery model had a neutral to slightly positive impact on staff satisfaction with the process and structural aspects of the program related to continuity of care and the delivery of services. During the survey period, staff reported an increase in the program's ability to provide a continuous therapeutic relationship to clients, an increased level of staff collaboration, but no change in opportunities for professional development. Staff also saw improvements in staffing levels and the support from management; however this trend was not observed in both groups (SLPs and non-SLPs). Many of the process and structural aspects specifically related to Early Expressions speech and language pathologists remained stable over the study period.
The small sample size limited our ability to measure statistical changes in satisfaction with the process and structural aspects of service delivery and to make statistical comparisons between and within groups.
Once data collection and analysis for the parent component of this CQI initiative is completed, a comprehensive overview of the change to service delivery, its impact on provider and parent satisfaction, and program recommendations will be presented.