Post-discharge “continuum of care” clinical pathway for persons with severe neurodisabilities—qualitative research to assess its concept and practicality after implementation

Although the CP was not challenged conceptually by the field experience, the teams implementing the intersectoral collaboration faced major challenges with the continuum of care approach. Most importantly, a lack of, and variability in, qualified therapeutic resources, as well as the fact that multiprofessional team approaches were not established as a healthcare standard in the community, were noted. While the research findings support the need for a situation analysis and targeted implementation efforts, they also indicate the potential for such a hybrid collaborative center- and community-based healthcare approach for a clientele with highly specialized healthcare needs.