Does the Synergy Model Implementation Improve the Transition from In-Hospital to Primary Care? The Experience from an Italian Cardiac Surgery Unit, Perspectives, and Future Implications

• Published in: International journal of environmental research and public health Vol. 19; no. 9; p. 5624
• Main Authors: Dellafiore, Federica, Caruso, Rosario, Nania, Tiziana, Pittella, Francesco, Fiorini, Tiziana, Caruso, Maria Paola, Zaffino, Giovanni, Stievano, Alessandro, Arrigoni, Cristina
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 05.05.2022; MDPI
• Subjects: Certification; Chronic illnesses; Clinical outcomes; Communication; Decision making; Health care; Heart; Heart surgery; Nurses; Nursing care; Patients; Primary care; Professionals; Rehabilitation; Surgery; organizational; Synergy Model; discursive paper; healthcare system; primary care; patient-centered model; care
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph19095624

The demand for care services in the healthcare system has changed and is triggering a smooth transition from in-hospital to primary care. In this regard, patient-centered-care models of care delivery might provide a framework to follow patients' journeys throughout their transition between different levels of care. Accordingly, an Italian research group at a cardiac hospital in Northern Italy implemented the Synergy Model in a Cardiac Surgery Unit, a patient-centered-care model, and is using the framework of the model to guide a smooth transition of patients towards rehabilitation and primary care after their hospitalization. This discursive paper is focused on the experience, perspectives, and future implications of adopting the Synergy Model to facilitate the transition from in-hospital to primary care. The presented experience and discussion might be helpful to the international debate regarding the strategies to boost a smooth transition from in-hospital to primary care.