Improving continuity of care by evaluation of post-discharge outcomes

Evaluation of nursing care is being expanded to identify and assure attainment of patient outcomes. Ideally, evaluation of care will occur throughout all phases of treatment and include perceptions of the patient and/or significant others. A framework for patient outcomes as proposed by Marek (1989) was useful in defining outcomes for newly injured and chronically skin-compromised patients with spinal cord injury. Guidelines established by the Joint Commission for Accreditation of Health Organizations also influenced development of the nursing quality assurance approach. A pilot program demonstrated attainment of expected patient outcomes for high-risk and problem-prone aspects of nursing care.