In the maternity ward where I work in Cambodia, we made a deliberate structural change: generalist doctors were given explicit responsibility for continuity of care across shifts.
This meant that one clinician consistently followed blood pressure trends, lab results, and clinical changes from admission through discharge, even as different specialists rotated through the service. It also meant consolidating information before rounds and providing structured verbal handovers, not just written notes.
In practice, this changed how risk was detected. Subtle but consistent blood pressure rises, early neurological symptoms, or small changes in a mother’s condition were more likely to be noticed and addressed before escalation. These were often patterns that did not trigger formal chart alarms but became clear through repeated bedside assessment.
Continuity also changed how families engaged with care. When one clinician repeatedly explained medications, warning signs, and next steps — especially during stressful situations like preeclampsia or late-night emergency admissions — anxiety decreased and cooperation improved. Families were more likely to recognize danger signs early and return for follow-up as advised.
What stands out to me is that this approach required little additional funding or equipment. It required clear role definition, protected time for handovers, and recognition that continuity itself is a safety intervention.
I would be very interested to hear from others in HIFA:
Have you seen similar generalist–specialist models improve inpatient care?
What barriers exist to assigning clear ownership for continuity?
How do health systems balance specialist workload with the need for consistent bedside oversight?
These questions feel increasingly relevant in settings where specialist capacity is limited but maternal care demand continues to rise.
Dr Viengchan Sek
GP supporting Ob/gyn
HIFA profile: Viengchan Sek is a General Practitioner at Orchid Hospital, Cambodia. Professional interests include improving access to reliable health information in low-resource settings, maternal and newborn health, evidence-based clinical practice, health literacy, digital health innovations, and strengthening healthcare systems through quality improvement and clinical guideline implementation. viengchansek777 AT gmail.com