Doing more with less and less with more.

The "devil is in the details" of any policy response. What forms such changes may take, and what research informs them, are critical to the profession as a whole and to practitioners on a daily basis. Research partnerships between home care agencies and university professors may provide rigorous, systematic, and validated findings necessary for meaningful solutions (Plotkin & Roche, 2000). The evidence of a dialogue between nursing researchers, home healthcare practitioners, and policymakers anticipating impacts on practice of changing fiscal and information-gathering requirements is scant. Such issues are in need a priority discussion by agencies, and collaborative investigative efforts between all involved.

A continuity of care integrated literature review, Part 2: Methodological issues.

PURPOSE: In Part 2 of this two-part series, research designs, methods, and measurement of continuity of care are explored. DESIGN: Qualitative, integrated literature review of a sample of 38 continuity of care nursing research article published 1990-1995. METHODS: Ganong's (1987) stages of the integrative literature research review process were followed. A data collection tool was designed and pilot tested, and rules for data analysis and interpretation were established. Research articles were systematically analyzed and reported using descriptive analysis. FINDINGS: Results showed few nursing models, primarily convenience sampling and nonexperimental cross-sectional study designs, varied data collection methods, and inadequate instrumentation. Measurement criteria were diverse and influenced by the perspectives of the measurer. CONCLUSIONS: Continuity of patient care was identified as a construct comprised of many related and tangential concepts in need of more sophisticated review. Recommendations for researchers are discussed.

Integrated literature review of continuity of care: Part 1, Conceptual issues.

PURPOSE: Continuity of patient care is a fundamental tenet of professional nursing, yet comprehension of the concept and related issues remains elusive. The purpose of this study was to explore issues associated with definitions, related concepts, and research methods of continuity of care through systematic literature-based study. In Part 1 of this two-part series, definitions and related concepts, factors, and variables associated with continuity of care were explored. DESIGN: Qualitative, integrated literature review of a sample of 38 nursing research articles about continuity of care, 1990-1995. METHODS: Ganong's (1987) stages of an integrative research review guided this study. A data collection tool was developed and pilot tested, and rules for data analysis and interpretation were established. Research articles were systematically analyzed and reported using descriptive analysis. FINDINGS AND CONCLUSIONS: No consensus was found in the literature about the conceptual definition of continuity of care. Continuity of patient care is a multifactorial concept affected by environmental influences, communication, patient, professional, and system factors.