Sometimes medical specialists are consulted in the primary care setting by GPs. This is a third category of transmural care.
Also in the nursing field are the specialized transmural nurses. They carry out activities that have traditionally been the domain of doctors, for instance for diabetic or asthma patients.
They work in outpatient departments and make home visits.
A fifth category takes place between secondary and tertiary care, namely hospitals and nursing homes. Because of the waiting lists for nursing homes, a growing number of hospitals have either opened their own rehabilitation wards or have developed partnerships with local nursing homes to facilitate the transfer of patients.
In the area of pharmacology a growing number of initiatives are being undertaken, ranging from the provision of medication for the first few days following hospital discharge, to delivering in-home medication for intravenous therapy.
A last category of transmural care is the nurse who is employed by a home care organization but is working within the hospital. She visits patients that go home to define, within the hospital, the kind of care that they will need when they get home. In this way the continuity of care is guaranteed.
