Journal articles: 'Coordination of health care'

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Vassbotn, Ane Drougge, Hege Sjøvik, Trond Tjerbo, Jan Frich, and Ivan Spehar. "General practitioners’ perspectives on care coordination in primary health care: A qualitative study." International Journal of Care Coordination 21, no. 4 (December 2018): 153–59. http://dx.doi.org/10.1177/2053434518816792.

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Introduction To explore Norwegian general practitioners’ experiences with care coordination in primary health care. Methods Qualitative study using data from five focus groups with 32 general practitioners in Norway. We analysed the data using systematic text condensation, a descriptive and explorative method for thematic cross-case analysis of qualitative data. Results The general practitioners had different notions of care pathways. They expressed a wish and an obligation to be involved in planning and coordination of primary health-care services, but they experienced organisational and financial barriers that limited their involvement and contribution. General practitioners reported lack of information about and few opportunities for involvement in formal coordination initiatives, and they missed informal arenas for dialogue with other primary health-care professionals. They argued that the general practitioner’s role as coordinator should be recognised by other parties and that they needed financial compensation for contributions and attendance in meetings with the municipality. Discussion General practitioners need informal arenas for dialogue with other primary health-care professionals and access to relevant information to promote coordinated care. There might be an untapped potential for improving patient care involving general practitioners more in planning and coordinating services at the system level. Financial compensation of general practitioners contribution may promote increased involvement by general practitioners.

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David Bates, W. "Health Information Technology and Care Coordination:The Next Big Opportunity for Informatics?" Yearbook of Medical Informatics 24, no. 01 (August 2015): 11–14. http://dx.doi.org/10.15265/iy-2015-020.

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SummaryThe costs of care in the U.S. are very high, in part because canre is relatively uncoordinated. To begin to address this and other issues, health care reform was passed, including the notion of accountable care. Under acountable care arrangements, providers are at risk for the costs of the care they provide to groups of patients. Evaluation of costs has made it clear that a large proportion of these costs are in the post-acute setting, and also that many specific problems such as adverse events and unnecessary readmissions occur following transitions. However, the electronic health records of today do not provide a great deal of assistance with the coordination of care, and even the best organizations have relatively primitive systems with respect to care coordination, even though communication is absolutely central to better coordination of care and health information technology (HIT) is a powerful lever for improving communication. This paper identifies specific gaps in care coordination today, presents a framework for better coordinating care using HIT, then describes how specific technologies can be leveraged. Also discussed are the need to build and test specific interventions to improve HIT-related care coordination tools, and the key policy steps needed to accomplish this.

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Naccarella, Lucio, Richard H. Osborne, and Peter M. Brooks. "Training a system-literate care coordination workforce." Australian Health Review 40, no. 2 (2016): 210. http://dx.doi.org/10.1071/ah15014.

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People with chronic complex conditions continue to experience increasing health system fragmentation and poor coordination. To reverse these trends, one solution has been an investment in effective models of care coordination that use a care coordinator workforce. Care coordinators are not a homogenous workforce – but an applied professional role, providing direct and indirect care, and is often undertaken by nurses, allied health professionals, social workers or general practitioners. In Australia, there is no training curriculum nor courses, nor nationally recognised professional quality standards for the care coordinator workforce. With the growing complexity and fragmentation of the health care system, health system literacy – shared understanding of the roles and contributions of the different workforce professions, organisations and systems, among patients and indeed the health workforce is required. Efforts to improve health system literacy among the health workforce are increasing at a policy, practice and research level. However, insufficient evidence exists about what are the health system literacy needs of care coordinators, and what is required for them to be most effective. Key areas to build a health system literate care coordination workforce are presented. Care coordination is more than an optional extra, but one of the only ways we are going to be able to provide equitable health services for people with chronic complex conditions. People with low health literacy require more support with the coordination of their care, therefore we need to build a high performing care coordinator workforce that upholds professional quality standards, and is health literacy responsive.

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Vrijhoef, Hubertus JM. "Changing perspectives: From care coordination to health coordination." International Journal of Care Coordination 24, no. 3-4 (September 2021): 89–90. http://dx.doi.org/10.1177/20534345211068674.

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Ploylearmsang, Chanuttha, Chutamat Somboon, Utoomporn Namdee, and Saithip Suttiruksa. "Managing health care needs of the elderly through an elderly care manager: Thailand." F1000Research 11 (June 21, 2022): 680. http://dx.doi.org/10.12688/f1000research.122555.1.

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Background: This mixed method research aimed to investigate health needs of older people and the attributes of the Elderly Care Managers (ECMs), and to evaluate the outcomes of two ECMs coordination. Methods: Three phases were: 1) a field survey of the health needs of 94 older persons; 2) group discussions between ten relevant persons involved in ECMs characteristics; 3) two ECMs coordinating with health-related agencies and measuring the outcomes of older people who needed assistance. Results: 63.1% of the participants had difficulties with their health, 12.8% of them had no caregiver, 26.6% of them had >1 health condition. Group talks dealt with the characteristics, role and attributes of ECMs. The two-month of ECMs coordination with health-related agencies according to older adults' needs, and made home visits encouraged the aged to acquire knowledge on their diseases. Conclusion: ECMs’s coordination with health-related agencies could support the needs of those of advanced age.

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Srivastava, Shefali, and Gyan Prakash. "Care coordination in the health-care service delivery: an elderly care perspective." Journal of Indian Business Research 11, no. 4 (November 18, 2018): 388–404. http://dx.doi.org/10.1108/jibr-09-2018-0235.

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Purpose The purpose of this study is to assess the relationship between patient-centricity, care coordination and delivery of quality care for older people with multiple chronic conditions. Care coordination is defined as a process where physicians, nurses and allied professionals work together to clarify responsibilities, care objectives, treatment plans and discharge plans for delivery of unified care. Patient-centricity is defined as an approach of delivering quality care to patients that focuses on creating a positive experience for them. Design/methodology/approach A literature review was used to identify measures of care coordination and then partial least square structural equation modeling was used to assess interrelationship among patient-centricity, measures of care coordination and delivery of quality care. Findings Results reveal that care coordinated pathways consist of IT-enabled coordination, interprofessional teamwork, information sharing and facilitative infrastructure requirements and are influenced by patient-centricity. These are deliberate requisites for delivering of quality care. Results of this study present a validated model of care coordination for older people, which may be further explored to refine the concept of care coordination. Practical implications Based on these results, practitioners may develop an overarching strategy to deliver seamless care and to achieve better health outcomes. Measures of care coordination may be used as a performance benchmarking tool and will also help in the process mapping of hospitals. Social implications This paper highlights how patient-centricity may be achieved by focusing on coordinated care processes. This understanding may help in designing processes, which in turn deliver health as a social good in an effective manner. Originality/value Results of this study present such a validated model for care coordination, which can be used by researchers.

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Hubcikova, Katarina, Tomas Rakus, Lucia Bruncvik, Zuzana Pechanova, and Jitka Buskova. "CARE COORDINATION LETTER IN PSYCHOGENIC NONEPILEPTIC SEIZURES WORKS - CASE REPORT." PSYCHIATRIA DANUBINA 33, no. 4 (December 16, 2021): 586–88. http://dx.doi.org/10.24869/psyd.2021.586.

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Mezuk, Briana, Weidi Qin, Linh Dang, and Rodlescia Sneed. "CARE COORDINATION, HEALTH OUTCOMES, AND HEALTHCARE UTILIZATION AMONG ADULTS WITH MULTIMORBIDITY." Innovation in Aging 6, Supplement_1 (November 1, 2022): 22. http://dx.doi.org/10.1093/geroni/igac059.082.

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Abstract Care coordination is a vehicle for improving patient-provider and provider-provider communication to improve outcomes and reduce unnecessary healthcare utilization, particularly for adults with multimorbidity. However, the clinical effectiveness of coordination at the population level remains unknown. This study examined the association between experiences of care coordination with subsequent health and healthcare outcomes among US adults over age 50. The analytic sample (n=695) included respondents from the Health and Retirement Study who had at least two chronic conditions, completed an Experimental Module on Coordinated Care in 2016, and were re-interviewed in 2018. Three domains of care coordination were examined as predictors: perceptions of coordination; using tangible supports (e.g., seeing a care coordinator); and using technical supports (e.g., patient portal). A range of outcomes related to health (i.e., self-rated health, functioning, pain) and healthcare (i.e., medication adherence, visits, hospitalizations, care satisfaction) were assessed in 2018. Weighted linear and logistic regression models, adjusted for demographic and socioeconomic characteristics, were fit for each lagged outcome. Higher engagement with tangible supports was positively associated with subsequent hospitalization (OR: 1.08, 95%CI: 1.01-1.15), greater pain (OR: 1.11 , 95%CI: 1.03-1.20), and marginally worse self-rated health (B=-0.02, p< 0.063). Better perceptions of coordination were also positively associated with care satisfaction (B=0.03, p< 0.020). Care coordination was not associated with functioning, adherence, or number of medical visits. Findings indicate the salience of tangible support for coordination among older adults with multi-morbidity, and that positive perceptions of coordination contribute to healthcare satisfaction.

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Sun, Wenjun, Katherine A. Kuehn, Douglas A. Wiegmann, Amye Tevaarwerk, and Mary E. Sesto. "Care Coordination Models Applied to Cancer Survivorship." Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care 3, no. 1 (June 2014): 217–21. http://dx.doi.org/10.1177/2327857914031036.

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Fragmented and uncoordinated care following active cancer treatment is an important public health problem for many of the 13 million adult cancer survivors not receiving necessary or routine follow-up care. Patients may receive surgery, radiotherapy, or chemotherapy in different departments or health care organizations. The coordination among and between multiple care providers, survivors, and family members is of great importance to cancer survivors to ensure optimal care. While frameworks and models are widely used to guide coordination improvement efforts for chronic diseases, the diversity of these models makes it difficult to choose which model is the best fit for coordinating cancer survivors’ care. This paper analyzes common models used for coordinating chronic and complex disease care to identify key elements in the models that are essential for successfully applying a model to cancer survivors to improve their care coordination.

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Steaban, Robin Lea. "Health Care Reform, Care Coordination, and Transformational Leadership." Nursing Administration Quarterly 40, no. 2 (2016): 153–63. http://dx.doi.org/10.1097/naq.0000000000000158.

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Khullar, Dhruv, and Dave A. Chokshi. "Can Better Care Coordination Lower Health Care Costs?" JAMA Network Open 1, no. 7 (November 2, 2018): e184295. http://dx.doi.org/10.1001/jamanetworkopen.2018.4295.

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Dwyer, Judith, and Sandra G. Leggat. "Care coordination and health sector reform." Australian Health Review 28, no. 3 (2004): 253. http://dx.doi.org/10.1071/ah040253.

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THE PRODUCTIVITY COMMISSION (Productivity Commission 2004) has nominated nationally coordinated health sector reform as one of two top priorities (along with natural resource management) for extending the industry reform agenda under the aegis of National Competition Policy. This is in recognition of the importance of these areas for the wellbeing of Australians, and the level of resources they will require in future years. The Commission states that ?an independent review of Australia?s health system as a whole is a critical first step in achieving cooperative solutions to deep-seated structural problems? (p. XI). The fragmentation in health system governance that results from the national? state split is mirrored in the lack of coordinated care at many levels throughout the system. The Commission?s proposal has been welcomed by many in the health industry, no doubt with some nervousness, because of the broad and deep conviction that something has to change in the apparently intractable problem of split funding responsibilities. ?Today?s health-care delivery systems are not organized in ways that promote best quality. Service delivery is largely uncoordinated, requiring steps and patient ?hand-offs? that slow down care and decrease rather than improve patient safety? (OECD 2004). Improving care coordination is high on the list of issues to be addressed in any reform of the health sector. This issue of the journal features a collection of papers which address the sometimes jagged ?seams? in the current system. They offer insights into some of the consequences of the structural problems the Productivity Commission would like to see addressed, and document an energetic search for methods of enhancing the effectiveness of health care.

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Gregg, W., and O. Steichen. "Health Information Technology Coordination to Support Patient-centered Care Coordination." Yearbook of Medical Informatics 24, no. 01 (August 2015): 34–37. http://dx.doi.org/10.15265/iy-2015-027.

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Summary Objective: To select papers published in 2014, illustrating how information technology can contribute to and improve patient-centered care coordination.Method: The two section editors performed a literature review from Medline and Web of Science to select a list of candidate best papers on the use of information technology for patient-centered care coordination. These papers were peer-reviewed by external reviewers and three of them were selected as “best papers”. Results: The first selected paper reports a qualitative study exploring the gap between current practices of care coordination in various settings and idealized longitudinal care plans. The second selected paper illustrates several unintended consequences of HIT designed to improve care coordination. The third selected paper shows that advanced analytic techniques in medical informatics can be instrumental in studying patient-centered care coordination. Conclusions: The realization of true patient-centered care coordination is dependent upon a number of factors. Standardization of clinical documentation and HIT interoperability across organization and settings is a critical prerequisite for HIT to support patient-centered care coordination. Enabling patient involvement is an efficient means for goal setting and health information sharing. Additionally, unintended consequences of HIT tools (both positive and negative) must be measured and taken into account for quality improvement.

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Prætorius, Thim. "Improving care coordination using organisational routines." Journal of Health Organization and Management 30, no. 1 (March 21, 2016): 85–108. http://dx.doi.org/10.1108/jhom-07-2013-0141.

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Purpose – The purpose of this paper is to systematically apply theory of organisational routines to standardised care pathways. The explanatory power of routines is used to address open questions in the care pathway literature about their coordinating and organising role, the way they change and can be replicated, the way they are influenced by the organisation and the way they influence health care professionals. Design/methodology/approach – Theory of routines is systematically applied to care pathways in order to develop theoretically derived propositions. Findings – Care pathways mirror routines by being recurrent, collective and embedded and specific to an organisation. In particular, care pathways resemble standard operating procedures that can give rise to recurrent collective action patterns. In all, 11 propositions related to five categories are proposed by building on these insights: care pathways and coordination, change, replication, the organisation and health care professionals. Research limitations/implications – The paper is conceptual and uses care pathways as illustrative instances of hospital routines. The propositions provide a starting point for empirical research. Practical implications – The analysis highlights implications that health care professionals and managers have to consider in relation to coordination, change, replication, the way the organisation influences care pathways and the way care pathways influence health care professionals. Originality/value – Theory on organisational routines offers fundamental, yet unexplored, insights into hospital processes, including in particular care coordination.

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Van Speybroeck, Alexander, Patricia Beierwaltes, Betsy Hopson, Suzanne McKee, Lisa Raman, Ravindra Rao, and Rebecca Sherlock. "Care coordination guidelines for the care of people with spina bifida." Journal of Pediatric Rehabilitation Medicine 13, no. 4 (December 22, 2020): 499–511. http://dx.doi.org/10.3233/prm-200738.

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Care coordination is the deliberate organization of patient care activities between two or more participants (including the patient) involved in a person’s care to facilitate the appropriate delivery of health care services. Organizing care involves the marshalling of personnel and other resources needed to carry out all required patient care activities. It is often managed by the exchange of information among participants responsible for different aspects of care [1]. With an estimated 85% of individuals with Spina Bifida (SB) surviving to adulthood, SB specific care coordination guidelines are warranted. Care coordination (also described as case management services) is a process that links them to services and resources in a coordinated effort to maximize their potential by providing optimal health care. However, care can be complicated due to the medical complexities of the condition and the need for multidisciplinary care, as well as economic and sociocultural barriers. It is often a shared responsibility by the multidisciplinary Spina Bifida team [2]. For this reason, the Spina Bifida Care Coordinator has the primary responsibility for overseeing the overall treatment plan for the individual with Spina Bifida[3]. Care coordination includes communication with the primary care provider in a patient’s medical home. This article discusses the Spina Bifida Care Coordination Guideline from the 2018 Spina Bifida Association’s Fourth Edition of the Guidelines for the Care of People with Spina Bifida and explores care coordination goals for different age groups as well as further research topics in SB care coordination.

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Wagner, Edward H., Nirmala Sandhu, Katie Coleman, Kathryn E. Phillips, and Jonathan R. Sugarman. "Improving Care Coordination in Primary Care." Medical Care 52 (November 2014): S33—S38. http://dx.doi.org/10.1097/mlr.0000000000000197.

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Basto, Luzia Beatriz Rodrigues, Maria Alves Barbosa, Claci Fátima Weirich Rosso, Lizete Malagoni de Almeida Cavalcante Oliveira, Ilma Pastana Ferreira, Diniz Antonio de Sena Bastos, Ana Cláudia Jaime de Paiva, and Alex De Assis Santos dos Santos. "Practices and challenges on coordinating the Brazilian Unified Health System." Revista de Saúde Pública 54 (February 13, 2020): 25. http://dx.doi.org/10.11606/s1518-8787.2020054001512.

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OBJECTIVE: To analyze the obstacles and challenges faced by managers and coordination professionals in their practices in municipal coordinating centers. METHODS: An exploratory descriptive study with a qualitative focus, applied in 40 managers and coordination professionals, from September 2017 to November 2018, with semi-structured interviews, resulting in two categories of analysis: limiting factors and factors that facilitate the management and operationalization of the Brazilian Unified Health System (SUS) coordinating sector. RESULTS: Analyzing the statements, we found evidence of the following limiting factors: failure in the criteria of referral, unavailability of beds, high demand, systemic difficulties in relation to the coordinating system, procedures of difficult scheduling and execution, increased repressed demand for elective procedures and difficulties in the flow of information between primary care and coordination. In the category of facilitating factors, the most significant possibilities were: expansion of the capability to know the user’s reality, improvement in primary care and increase in health financial resources, health training and education and restructuring, in addition to reorganizing internal coordinating procedures. CONCLUSION: The limiting factors of coordination show the need to promote actions that offer all SUS users full access to health services.

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Gupta, Vidya Bhushan, Karen G. O’Connor, and Carlos Quezada-Gomez. "Care Coordination Services in Pediatric Practices." Pediatrics 113, Supplement_4 (May 1, 2004): 1517–21. http://dx.doi.org/10.1542/peds.113.s4.1517.

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Objective. To examine the frequency with which pediatricians provide care coordination services to children, particularly those with special health care needs, in their practices and the barriers to providing these services. Methods. An 8-page questionnaire was mailed to 1632 randomly selected US members of the American Academy of Pediatrics. Results. The response rate was 56.7%. Most pediatricians (71.2%) reported that they or someone in their practice serves as the primary care coordinator for their children with special needs, but fewer than one fourth (23.3%) always contact the school about the child’s health and educational needs as part of care coordination, only 18.7% always schedule time with the child’s family to discuss the findings of a specialist, and only 23.2% meet with the discharge planning team to facilitate transition from hospital to home. The respondents identified the 2 top barriers that impede this activity: limited time and lack of medical staff in their offices. Conclusions. Although most pediatricians believe that they are providing care coordination services, when asked about specific care coordination activities, such as contacting the school or scheduling time with the family to discuss the findings of a specialist, many do not provide these services.

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Ding, Kedong. "The Myth of Care Coordination: Whether Professional Care Coordination Improved Older Adults’ Health Outcomes?" Innovation in Aging 5, Supplement_1 (December 1, 2021): 1049. http://dx.doi.org/10.1093/geroni/igab046.3746.

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Abstract Background: Current evidence on the effects of Care Coordination (CC) on older adults’ well-being and health service utilization is inconsistent. Previous studies are mostly limited to regional data and focus mostly on nurse-led CC instead of layperson Care Coordinators like family caregivers. This study explores the effects of having CC in a national sample of U.S. older adults and whether the coordinators’ professionalism impacts the effect of having CC on multidimensional health outcomes (Health outcomes were conceptualized as physical health, healthcare utilization, and care encounters). Methods: Data were from the 2016 and 2018 waves of the Health and Retirement Study (HRS) (n=1,372). Multivariate regression models were used to examine the effects of CC on multidimensional health outcomes in 2016 and the longitudinal effects of having CC. We also tested the effect of Care Coordinators’ professionalism on the multidimensional health outcomes. All models controlled for sociodemographic characteristics and health status. Results: Findings suggest that having CC doesn’t have a positive effect on older adults’ health outcomes. Having CC was associated with an increased number of acute diseases (β = 0.16, p < .001) and nonacute diseases (β = 0.21, p < .01) in longterm. The results regarding cross-sectional effects show that receiving care from a Coordinator was related to increased health service utilization. Participants with professional Care Coordinators were more likely to report receiving person-centered care (OR=1.60, p<.05). Conclusion: This study demonstrates the limited effects of CCs on older adults’ physical health outcomes, and emphasized the importance of care coordinators’ qualifications.

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Aliotta, Sherry. "Coordination of care." Case Manager 14, no. 2 (March 2003): 49–52. http://dx.doi.org/10.1067/mcm.2003.22.

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Moreno, Megan A. "Pediatric Care Coordination." JAMA Pediatrics 173, no. 1 (January 1, 2019): 112. http://dx.doi.org/10.1001/jamapediatrics.2018.4112.

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Popejoy, Lori L., Mohammed A. Khalilia, Mihail Popescu, Colleen Galambos, Vanessa Lyons, Marilyn Rantz, Lanis Hicks, and Frank Stetzer. "Quantifying care coordination using natural language processing and domain-specific ontology." Journal of the American Medical Informatics Association 22, e1 (October 16, 2014): e93-e103. http://dx.doi.org/10.1136/amiajnl-2014-002702.

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Abstract Objective This research identifies specific care coordination activities used by Aging in Place (AIP) nurse care coordinators and home healthcare (HHC) nurses when coordinating care for older community-dwelling adults and suggests a method to quantify care coordination. Methods A care coordination ontology was built based on activities extracted from 11 038 notes labeled with the Omaha Case management category. From the parsed narrative notes of every patient, we mapped the extracted activities to the ontology, from which we computed problem profiles and quantified care coordination for all patients. Results We compared two groups of patients: AIP who received enhanced care coordination (n=217) and HHC who received traditional care (n=691) using 128 135 narratives notes. Patients were tracked from the time they were admitted to AIP or HHC until they were discharged. We found that patients in AIP received a higher dose of care coordination than HHC in most Omaha problems, with larger doses being given in AIP than in HHC in all four Omaha categories. Conclusions ‘Communicate’ and ‘manage’ activities are widely used in care coordination. This confirmed the expert hypothesis that nurse care coordinators spent most of their time communicating about their patients and managing problems. Overall, nurses performed care coordination in both AIP and HHC, but the aggregated dose across Omaha problems and categories is larger in AIP.

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Chang, Ji, Dave Chokshi, and Joseph Ladapo. "Coordination Across Ambulatory Care." Journal of Ambulatory Care Management 41, no. 2 (2018): 128–37. http://dx.doi.org/10.1097/jac.0000000000000227.

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van Achterberg, Theo, Fred C. J. Stevens, Marion J. H. Hekkink, Harry F. J. M. Crebolder, and Hans Philipsen. "Implementing Coordination of Care." Scandinavian Journal of Caring Sciences 9, no. 4 (December 1995): 209–17. http://dx.doi.org/10.1111/j.1471-6712.1995.tb00416.x.

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Phillips, C. "Care Coordination for Primary Care Practice." Journal of the American Board of Family Medicine 29, no. 6 (November 1, 2016): 649–51. http://dx.doi.org/10.3122/jabfm.2016.06.160312.

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Presler, Betty. "Care Coordination for Children with Special Health Care Needs." Orthopaedic Nursing 17, Suppl. 2 (March 1998): 45???52. http://dx.doi.org/10.1097/00006416-199803001-00010.

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M. Lancaster, Monica, and David P. Thow. "Care Coordination: A Case Study Linking Primary Health Care." Australian Journal of Primary Health 7, no. 1 (2001): 82. http://dx.doi.org/10.1071/py01013.

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The purpose of this project is to demonstrate, through a case study, how York Community Services (YCS) is a leader in the delivery of primary health care through its integration of health, legal and social services. YCS is located in Toronto, Ontario, Canada. YCS's mandate is to serve populations that have traditionally been on the margins of society and therefore have had difficulty accessing the health care system. These include victims of domestic violence, the isolated senior, those with severe mental illness and children living in poverty. Care coordination is a unique model developed by YCS whose main goal is to provide a forum for the client's providers to meet, discuss and coordinate relevant information. Care coordination is used to maintain continuity of care among providers.

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Pinto, Erika Simone Galvão, Rosimeire Fontes de Queiroz, Gisele Santana Pereira Carreiro, Luana Jordana Morais, Eliabe Rodrigues de Medeiros, and Tereza Cristina Scatena Villa. "Coordination of health care with the community in the clinical management of tuberculosis." Revista Brasileira de Enfermagem 71, no. 3 (May 2018): 1122–27. http://dx.doi.org/10.1590/0034-7167-2017-0255.

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ABSTRACT Objective: determine the coordination of Primary Health Care with community resources in the clinical management of tuberculosis. Method: descriptive study, of quantitative approach, with participation of one hundred health professionals. Part of a questionnaire was used in evaluating local institutional capacity for the model of chronic conditions care, adapted for tuberculosis care. Results: the coordination between health units, individuals with tuberculosis, and community organizations; the partnerships between institutions and local health councils/committees showed limited capacity. On the other hand, the component for the participation of the Community Health Agent presented more favorable capacity. Conclusion: the municipality has unfavorable capacity for coordination of health units and the community. It is reinforced the need to promote these coordinations in search of symptomatic cases in the communities, in the directly observed treatment, and in promoting the association between different social actors.

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Findley, Sally, Michael Rosenthal, Tyra Bryant-Stephens, Maureen Damitz, Marielena Lara, Carol Mansfield, Adriana Matiz, et al. "Community-Based Care Coordination." Health Promotion Practice 12, no. 6_suppl_1 (November 2011): 52S—62S. http://dx.doi.org/10.1177/1524839911404231.

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Care coordination programs have been used to address chronic illnesses, including childhood asthma, but primarily via practice-based models. An alternative approach employs community-based care coordinators who bridge gaps between families, health care providers, and support services. Merck Childhood Asthma Network, Inc. (MCAN) sites developed community-based care coordination approaches for childhood asthma. Using a community-based care coordination logic model, programs at each site are described along with program operational statistics. Four sites used three to four community health workers (CHWs) to provide care coordination, whereas one site used five school-based asthma nurses. This school-based site had the highest caseload (82.5 per year), but program duration was 3 months with 4 calls or visits. Other sites averaged fewer cases (35 to 61 per CHW per year), but families received more (7 to 17) calls or visits over a year. Retention was 43% to 93% at 6 months and 24% to 75% at 12 months. Pre–post cross-site data document changes in asthma management behaviors and outcomes. After program participation, 93% to 100% of caregivers had confidence in controlling their child’s asthma, 85% to 92% had taken steps to reduce triggers, 69% to 100% had obtained an asthma action plan, and 46% to 100% of those with moderate to severe asthma reported appropriate use of controller medication. Emergency department visits for asthma decreased by 36% to 63%, and asthma-related hospitalizations declined by 26% to 78%. More than three fourths had fewer school absences. In conclusion, MCAN community-based care coordination programs improved management behaviors and decreased morbidity across all sites.

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Banfield, Michelle A., Karen L. Gardner, Laurann E. Yen, Ian S. McRae, James A. Gillespie, and Robert W. Wells. "Coordination of care in Australian mental health policy." Australian Health Review 36, no. 2 (2012): 153. http://dx.doi.org/10.1071/ah11049.

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Objective. To review Australian mental health initiatives involving coordination of care. Methods. Commonwealth government websites were systematically searched for mental health policy documents. Database searches were also conducted using the terms ‘coordination’ or ‘integration’ and ‘mental health’ or ‘mental illness’ and ‘Australia’. We assessed the extent to which informational, relational and management continuity have been addressed in three example programs. Results. The lack of definition of coordination at the policy level reduces opportunities for developing actionable and measurable programs. Of the 51 mental health initiatives identified, the three examples studied all demonstrated some use of the dimensions of continuity to facilitate coordination. However, problems with funding, implementation, evaluation and competing agendas between key stakeholders were barriers to improving coordination. Conclusions. Coordination is possible and can improve both relationships between providers and care provided. However, clear leadership, governance and funding structures are needed to manage the challenges encountered, and evaluation using appropriate outcome measures, structured to assess the elements of continuity, is necessary to detect improvements in coordination. What is known about the topic? The issues of integration of services and coordination of care have been a part of the National Mental Health Strategy documents for almost 20 years, but reports and evaluations continually note a lack of solid progress on these reforms. What does this paper add? This paper examines how the key elements of continuity that underpin coordination have been addressed in three examples of Australian mental health initiatives aimed at improving integration and coordination. What are the implications for practitioners? Coordination of care for mental health is possible and can improve both relationships between providers and care provided, but attention should be paid to the role of informational, relationship and management continuity in program design and implementation.

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Bradley, Steven M., Pam Rush, Kim Wolf, Amin Rahmatullah, Robin Braun, Michael Samara, Alan J. Bank, et al. "Improving Value Through Heart Failure Care Coordination: The Allina Health Experience." Journal of the Minneapolis Heart Institute Foundation 2, no. 2 (December 2018): 9–13. http://dx.doi.org/10.21925/mplsheartjournal-d-18-00011.

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Reducing readmission following heart failure is emerging as a target of quality initiatives in the Centers for Medicare & Medicaid Services Hospital Readmission Reduction Program. In response to higher readmission rates than desired following heart failure (HF) hospitalization, Allina Health hospital's cardiovascular subspecialty care developed an HF nurse care coordinator program to reduce readmissions. The nurse HF care coordinator serves as the bridge to help manage care following hospital discharge and ensure adherence to protocols developed by the HF management program. This effort was initially developed and implemented at Mercy and Unity Hospital and was associated with a 4.3% reduction in HF readmissions. Subsequent expansion of the HF nurse care coordinator program to United and Abbott Northwestern Hospitals was associated similar reductions in HF readmissions. Concurrently, all-cause mortality at 6 months post-discharge was also significantly lower following implementation of the program (mortality pre-HF care coordinator program 12.6% vs. post-HF care coordinator program 18.8%, P = .047) in propensity matched analysis. The findings of this effort suggest the potential for care coordination programs to improve the care and outcomes of patients with HF.

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Iversen, Tor, Anders Anell, Unto Häkkinen, Christian Kronborg, and Thorhildur Ólafsdóttir. "Coordination of health care in the Nordic countries." Nordic Journal of Health Economics 4, no. 1 (April 26, 2016): 41–55. http://dx.doi.org/10.5617/njhe.2846.

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Coordination of health care exists at many different levels and in many different forms. We describe the similarities and differences in coordination mechanisms among the Nordic countries. In some respects, the Nordic countries approach coordination problems in similar ways although differences exist. The overall pattern shows that Finland and Sweden have less country-wide coordination compared with the other countries. There are many questions and few answers with regard to which mechanisms work best. Hence, coordination mechanisms in health care seem to be an important area for further research. We outline a few topics for future joint Nordic research in this area.Published: April 2016.

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Antonelli, Richard C., and Donna M. Antonelli. "Providing a Medical Home: The Cost of Care Coordination Services in a Community-Based, General Pediatric Practice." Pediatrics 113, Supplement_4 (May 1, 2004): 1522–28. http://dx.doi.org/10.1542/peds.113.s4.1522.

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Objective. To determine the cost of unreimbursable care coordination services for children with special health care needs (CSHCN) in 1 community-based, general pediatric practice. Methods. A measurement tool was developed to quantify the precise activities involved in providing comprehensive, coordinated care for CSHCN. Costs of providing this care were calculated on the basis of time spent multiplied by the average salary of the office personnel performing the care coordination service. In addition, data were collected regarding the complexity level of the patient requiring the service, the type of service provided, and the outcome. Results. During the 95-day study period, 774 encounters that led to care coordination activities were logged, representing service provision to 444 separate patients. When these encounters were examined on the basis of clinical complexity of the patient, the most complex patients constituted 11% of the population of CSHCN yet accounted for 25% of the encounters. In addition, care coordination activities for these clinically complex CSHCN engaged office staff 4 times as long when compared with less clinically complex CSHCN. Overall, 51% of the encounters were attributable to coordinating care for problems not considered typically medical and included activities such as processing referrals with managed care organizations, consulting with schools or other educational programs, and providing oversight for psychosocial issues. On the basis of national salary and benefits data, the annual cost of the time spent coordinating care for CSHCN in this medical home model ranged from $22 809 to $33 048 (representing the 25th and 75th percentiles, respectively). Conclusions. The costs of providing care coordination services to CSHCN in a medical home are appreciable but not prohibitive. Standardization of care coordination practices is essential because it makes the medical home more amenable to quality improvement interventions. Mechanisms to finance unreimbursable care coordination activities must be developed to achieve the Healthy People 2010 objective that all CSHCN have access to a medical home.

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Ranade-Kharkar, Pallavi, Charlene Weir, Chuck Norlin, Sarah A. Collins, Lou Ann Scarton, Gina B. Baker, Damian Borbolla, Vanina Taliercio, and Guilherme Del Fiol. "Information needs of physicians, care coordinators, and families to support care coordination of children and youth with special health care needs (CYSHCN)." Journal of the American Medical Informatics Association 24, no. 5 (March 24, 2017): 933–41. http://dx.doi.org/10.1093/jamia/ocx023.

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Abstract Objectives: Identify and describe information needs and associated goals of physicians, care coordinators, and families related to coordinating care for medically complex children and youth with special health care needs (CYSHCN). Materials and Methods: We conducted 19 in-depth interviews with physicians, care coordinators, and parents of CYSHCN following the Critical Decision Method technique. We analyzed the interviews for information needs posed as questions using a systematic content analysis approach and categorized the questions into information need goal types and subtypes. Results: The Critical Decision Method interviews resulted in an average of 80 information needs per interview. We categorized them into 6 information need goal types: (1) situation understanding, (2) care networking, (3) planning, (4) tracking/monitoring, (5) navigating the health care system, and (6) learning, and 32 subtypes. Discussion and Conclusion: Caring for CYSHCN generates a large amount of information needs that require significant effort from physicians, care coordinators, parents, and various other individuals. CYSHCN are often chronically ill and face developmental challenges that translate into intense demands on time, effort, and resources. Care coordination for CYCHSN involves multiple information systems, specialized resources, and complex decision-making. Solutions currently offered by health information technology fall short in providing support to meet the information needs to perform the complex care coordination tasks. Our findings present significant opportunities to improve coordination of care through multifaceted and fully integrated informatics solutions.

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Ngo, Victoria, Cynthia G. Matsumoto, Jill G. Joseph, Janice F. Bell, Richard J. Bold, Andra Davis, Sarah C. Reed, and Katherine K. Kim. "The Personal Health Network Mobile App for Chemotherapy Care Coordination: Qualitative Evaluation of a Randomized Clinical Trial." JMIR mHealth and uHealth 8, no. 5 (May 26, 2020): e16527. http://dx.doi.org/10.2196/16527.

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Background Cancer care coordination addresses the fragmented and inefficient care of individuals with complex care needs. The complexity of care coordination can be aided by innovative technology. Few examples of information technology-enabled care coordination exist beyond the conventional telephone follow-up. For this study, we implemented a custom-designed app, the Personal Health Network (PHN)—a Health Insurance Portability and Accountability Act-compliant social network built around a patient to enable patient-centered health and health care activities in collaboration with clinicians, care team members, caregivers, and others designated by the patient. The app facilitates a care coordination intervention for patients undergoing chemotherapy. Objective This study aimed to understand patient experiences with PHN technology and assess their perspectives on the usability and usefulness of PHNs with care coordination during chemotherapy. Methods A two-arm randomized clinical trial was conducted to compare the PHN and care coordination with care coordination alone over a 6-month period beginning with the initiation of chemotherapy. A semistructured interview guide was constructed based on a theoretical framework of technology acceptance addressing usefulness, usability, and the context of use of the technology within the participant’s life and health care setting. All participants in the intervention arm were interviewed on completion of the study. Interviews were recorded and transcribed verbatim. A summative thematic analysis was completed for the transcribed interviews. Features of the app were also evaluated. Results A total of 27 interviews were completed. The resulting themes included the care coordinator as a partner in care, learning while sick, comparison of other technology to make sense of the PHN, communication, learning, usability, and usefulness. Users expressed that the nurse care coordinators were beneficial to them because they helped them stay connected to the care team and answered their questions. They shared that the mobile app gave them access to the health information they were seeking. Users expressed that the mobile app would be more useful if it was fully integrated with the electronic health record. Conclusions The findings highlight the value of care coordination from the perspectives of cancer patients undergoing chemotherapy and the important role of technology, such as the PHN, in enhancing this process by facilitating better communication and access to information regarding their illness.

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Baicker, Katherine, and Helen Levy. "Coordination versus Competition in Health Care Reform." New England Journal of Medicine 369, no. 9 (August 29, 2013): 789–91. http://dx.doi.org/10.1056/nejmp1306268.

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Robinson, Karen M. "Care Coordination: A Priority for Health Reform." Policy, Politics, & Nursing Practice 11, no. 4 (November 2010): 266–74. http://dx.doi.org/10.1177/1527154410396572.

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May, Jeanette. "DMAA: Defining Quality in Health Care Coordination." Disease Management 9, no. 6 (December 2006): 371–75. http://dx.doi.org/10.1089/dis.2006.9.371.

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SCHNEIDER, MARY ELLEN. "Care Coordination Effective in Chronic Health Cases." Pediatric News 43, no. 2 (February 2009): 22. http://dx.doi.org/10.1016/s0031-398x(09)70060-8.

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Shannon, Elizabeth. "The devil is in the detail: lessons for multi-disciplinary care teams from alocal evaluation of coordinated care." Australian Health Review 25, no. 2 (2002): 87. http://dx.doi.org/10.1071/ah020087.

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The national evaluation report on the first round of Coordinated Care Trials focused on relationships of care coordination from two main perspectives: that of the General Practitioner (GP) as care coordinator; and the GP perception of non-GP care coordinators. As the majority of the Tasmanian care coordinators came from a nursing background and dealt with a wide range of health care providers, in addition to GPs, a more complex local analysis was required. It was found that relations between care coordinators and other health providers varied considerably by profession andnew strategies were required to ameliorate the resulting conflict. This aspect of the local evaluation provides useful lessons for analysing and avoiding some sources of conflict in the formation and functioning of multi-disciplinary health care teams.

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Kritzler, Annette M. "Coordination of Care—Minnesotaʼs Journey." Journal For Healthcare Quality 28, no. 5 (September 2006): 4. http://dx.doi.org/10.1111/j.1945-1474.2006.tb00624.x.

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Hobbs Knutson, Katherine, Mark J. Meyer, Nisha Thakrar, and Bradley D. Stein. "Care Coordination for Youth With Mental Health Disorders in Primary Care." Clinical Pediatrics 57, no. 1 (November 1, 2017): 5–10. http://dx.doi.org/10.1177/0009922817733740.

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Many children are treated for mental health disorders in primary care settings. The system of care (SOC) provides a framework for collaboration among pediatric mental health providers, but it is unclear if youth treated for mental health disorders in primary care receive such coordination. At the South Boston Community Health Center from September /2012 to August 2013 for 74 individuals ≤18 years, the odds of contact with SOC agencies (mental health, education, child protective services, juvenile justice and developmental disabilities) were compared for mental health treatment in primary versus specialty care. The odds of SOC contact within primary care were lower compared to specialty care (OR = 0.43, 95% CI = 0.29-0.66), specifically for mental health (OR = 0.54, 95% CI = 0.25-1.2), education (OR = 0.12, 95% CI = 0.050-0.28), and child protective services (OR = 0.64, 95% CI = 0.22-1.9). As care coordination may improve health outcomes, increased support and education for care coordination specific to youth treated for mental health disorders in primary care settings may be warranted.

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Prokop, Jackie. "Care Coordination Strategies in Reforming Health Care: A Concept Analysis." Nursing Forum 51, no. 4 (July 11, 2016): 268–74. http://dx.doi.org/10.1111/nuf.12157.

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Stille, Christopher J., and Richard C. Antonelli. "Coordination of care for children with special health care needs." Current Opinion in Pediatrics 16, no. 6 (December 2004): 700–705. http://dx.doi.org/10.1097/01.mop.0000144442.68016.92.

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Noyes, Katia, John R. T. Monson, Irfan Rizvi, Ann Savastano, James S. A. Green, and Nick Sevdalis. "Regional Multiteam Systems in Cancer Care Delivery." Journal of Oncology Practice 12, no. 11 (November 2016): 1059–66. http://dx.doi.org/10.1200/jop.2016.013896.

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Teamwork is essential for addressing many of the challenges that arise in the coordination and delivery of cancer care, especially for the problems that are presented by patients who cross geographic boundaries and enter and exit multiple health care systems at various times during their cancer care journeys. The problem of coordinating the care of patients with cancer is further complicated by the growing number of treatment options and modalities, incompatibilities among the vast variety of technology platforms that have recently been adopted by the health care industry, and competing and misaligned incentives for providers and systems. Here we examine the issue of regional care coordination in cancer through the prism of a real patient journey. This article will synthesize and elaborate on existing knowledge about coordination approaches for complex systems, in particular, in general and cancer care multidisciplinary teams; define elements of coordination derived from organizational psychology and human factors research that are applicable to team-based cancer care delivery; and suggest approaches for improving multidisciplinary team coordination in regional cancer care delivery and avenues for future research. The phenomenon of the mobile, multisystem patient represents a growing challenge in cancer care. Paradoxically, development of high-quality, high-volume centers of excellence and the ease of virtual communication and data sharing by using electronic medical records have introduced significant barriers to effective team-based cancer care. These challenges urgently require solutions.

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Reisman, Lonny, and Randall S. Krakauer. "Coordination Of Care In Medicare." Health Affairs 28, no. 2 (March 2009): 597–98. http://dx.doi.org/10.1377/hlthaff.28.2.597-a.

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Mattocks, Kristin M. "Care Coordination for Women Veterans." Medical Care 53 (April 2015): S8—S9. http://dx.doi.org/10.1097/mlr.0000000000000339.

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Scholz Mellum, Jean, Donna Martsolf, Greer Glazer, Grant Martsolf, and Barbara Tobias. "A mixed methods study of the experience of older adults with multimorbidity in a Care Coordination Program." International Journal of Care Coordination 21, no. 1-2 (March 7, 2018): 36–46. http://dx.doi.org/10.1177/2053434518762593.

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Introduction Care Coordination Programs are designed to streamline services for older adults with multimorbidity. The Triple Aim, a conceptual model for the design and evaluation of healthcare models, stipulates that a balance of three aims—reducing costs, improving population health, and improving patient experience—are needed for high-quality, value-based care. Research is beginning to show that coordinating care across the continuum of care reduces costs and improves the health of the multimorbid older adult population. Yet little is known about older adults’ experience of care and their overall assessment of interactions with healthcare providers across the length of time of these interactions in a Care Coordination Program. Methods To gain a deeper understanding of older adults’ experience with a Care Coordination Program, this concurrent mixed methods research study analyzed 201 older adults’ assessment of their chronic illness care using the Patient Assessment of Chronic Illness Care (PACIC+). A subset of 30 older adults also participated in a telephone interview to collect qualitative data. Results The experience of older adults with multimorbidity in a Care Coordination Program was related to two factors: (1) professional actions and (2) professional attitudes. Actions that improved patients’ experience of care were communication, coordination, and addressing fundamental problems. Professional attitudes that improved their experience of care included being compassionate, knowledgeable and professional, mutually respectful, and positive and encouraging. Discussion To improve patient experience, Care Coordination Programs must design and measure their efforts related to the actions and the attitudes of their care team, especially primary care physicians and care coordinators.

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Richardson, Joshua E., Joshua R. Vest, Cori M. Green, Lisa M. Kern, and Rainu Kaushal. "A needs assessment of health information technology for improving care coordination in three leading patient-centered medical homes." Journal of the American Medical Informatics Association 22, no. 4 (March 21, 2015): 815–20. http://dx.doi.org/10.1093/jamia/ocu039.

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Abstract Objective We investigated ways that patient-centered medical homes (PCMHs) are currently using health information technology (IT) for care coordination and what types of health IT are needed to improve care coordination. Materials and Methods A multi-disciplinary team of researchers conducted semi-structured telephone interviews with 28 participants from 3 PCMHs in the United States. Participants included administrators and clinicians from PCMHs, electronic health record (EHR) and health information exchange (HIE) representatives, and policy makers. Results Participants identified multiple barriers to care coordination using current health IT tools. We identified five areas in which health IT can improve care coordination in PCMHs: 1) monitoring patient populations, 2) notifying clinicians and other staff when specific patients move across care settings, 3) collaborating around patients, 4) reporting activities, and 5) interoperability. To accomplish these tasks, many participants described using homegrown care coordination systems separate from EHRs. Discussion The participants in this study have resources, experience, and expertise with using health IT for care coordination, yet they still identified multiple areas for improvement. We hypothesize that focusing health IT development in the five areas we identified can enable more effective care coordination. Key findings from this work are that homegrown systems apart from EHRs are currently used to support care coordination and, also, that reporting tools are key components of care coordination. Conclusions New health IT that enables monitoring, notifying, collaborating, reporting, and interoperability would enhance care coordination within PCMHs beyond what current health IT enables.

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Shing, Jaimie Z., Tiebin Liu, and Rodolfo Valdez. "Changes in care coordination and health insurance in the population of US children with muscular dystrophy, 2005–2006 and 2009–2010." International Journal of Care Coordination 21, no. 4 (December 2018): 140–52. http://dx.doi.org/10.1177/2053434518818448.

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Introduction We aimed to assess changes in care coordination and health insurance coverage among US children with muscular dystrophy. Methods We used 2005–2006 and 2009–2010 data from the National Survey of Children with Special Health Care Needs. We examined the distribution of sociodemographic and health characteristics of children with muscular dystrophy by survey cycle. Multivariable regression was used to calculate odds of not receiving effective care coordination, not having adequate health insurance coverage, receiving no help coordinating care, and having problems obtaining referrals in each survey cycle. Results In the 2005–2006 and 2009–2010 survey cycles, there were 135 and 117 children with muscular dystrophy (representing 34,672 and 31,169 US children with muscular dystrophy), respectively. The percentage of children with muscular dystrophy who did not receive effective care coordination changed from 59.2% (95% confidence interval (CI), 45.6%–72.7%) in 2005–2006 to 53.4% (95% CI, 38.3%–68.6%) in 2009–2010. The odds of not receiving effective care coordination (adjusted odds ratio (aOR) = 0.77; 95% CI, 0.32–1.89) or having problems obtaining referrals (aOR = 0.52; 95% CI, 0.17–1.59) did not change significantly between the two periods, whereas odds of having inadequate insurance coverage decreased significantly (aOR = 0.41, 95% CI, 0.18–0.93) and odds of not receiving help coordinating care increased significantly (aOR = 4.22, 95% CI, 1.24–14.29) between the two periods. Conclusion Our results suggest key health care needs for many families with children with muscular dystrophy have remained unmet for a prolonged period. Although there were significant improvements in health insurance coverage, nearly one-third of children with muscular dystrophy still had inadequate health insurance coverage in 2009–2010; it is likely that this situation has not changed much since then.

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Journal articles on the topic 'Coordination of health care'

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