Delivering chronic care to patients while assuming 24/7 emergency care: the culture and structure challenges of mixing chronic and acute care missions
A division of primary care in the largest and only public university hospital of a State in Switzerland must assume two missions: delivering chronic care to their patients and offereing emergency care 24/7 to the population. Organisation and recuperation of the staff delivering night and WE shift has a direct impact of the organization of delivering chronic care; it is desorganizing the agenda of healthcare professional taking care of chronic patients leading to discontinuity of the physician-patient relationship because of recuperation. Also the culture of chronic vs acute care is not the same and lead to a misalignment between healthcare professionals principles and their missions. How these two missions can be reconciled culturally and structurally ?