Case Study on Transfer of Care

Running head: CASE STUDY ON TRANSFER OF CARE
Case Study on Transfer of Care
Name of the student
Name of the university
Author note

1CASE STUDY ON TRANSFER OF CARE
Introduction:
The responsibility of caring for a person if alters among various service providers in
different locations, based on the person’s changing conditions and relevant care needs, it is
termed as transfer of care. If not approached properly, it leads to adverse events that pose a
negative impact on the people and the service provider system as well. Collaboration among
all the sectors can overcome the negative consequences of poor transfer and enable the people
to access the health and community services properly (Banfield et al. 2013).
Established goals:
The person of focus is Joseph Russo who lives in the suburb of Western Sydney,
Blacktown. His wife Sophia suffers from COPD and heart failure and her health was
deteriorating. Joseph cared for Sophia until he had an incident. He became unconscious after
prolonged exposure to carbon monoxide in his car. He suffered from hypotension, and
experienced delirium. Both he and his wife Sophia requires transfer of care. Blacktown
Community Health Services provide an array of care for all the people residing in the Eastern
sector of the town. People who suffer from chronic health issues are provided proper care to
improve their conditions. Services that provide care at people’s home are required for Joseph
and his family.
Principles of Transfer of Care:
The following principles aim at following a person centred care model rather than a
service-driven framework.
 Person- and Family- centred care: A collaboration of the patient, family and the
service provider to achieve better health and improve the well-being of the patient, by

2CASE STUDY ON TRANSFER OF CARE
making the patient the main focus. Since Joseph was not entirely convinced about the
care, making him and his wife the first priority should be helpful.
 Evidence based quality services: The professional use their prior experience and
knowledge to evaluate the available evidences that help them make shared decisions
(Holly and Poletick 2014). Joseph’s diagnosis as well as Sophia’s conditions are to be
evaluated for providing a better service to their family. The diagnosis of Joseph,
however would be kept confidential at all times.
 Equity in access to care: The patient and their family must be able to access the
available services and the support required, to fulfil the needs of the patient. Joseph
and Sophia’s requirements would be fulfilled at all times and it would be made sure
that they get to access the available health care services.
 A strength-based approach: It is of utmost importance that the patient’s capabilities
are identified and utilized to achieve their goals. Joseph used to be quite friendly and
communicative. Although his nature has changed in the past few years. Joseph would
be motivated to talk about his life, his childhood back in Italy, the time he spent with
his wife. This will help him regain his mental well-being and promote a positive
atmosphere around the Russo residence.
 Strong linkages and co-ordination across sectors: Working together to deliver the
services by thorough coordination, integrated approach and respectful
communication. Together with Joseph, Sophia and their daughter Emma, a
coordinated approach of care should be delivered.
 Interdisciplinary approach: Providing the needed support to the person of focus
with the help of various services to establish a holistic care approach. All the needs of
Joseph and his family should be administered and cared for, to promote health and
well-being of the entire family.