Practice-based chronic condition care coordination: challenges and opportunities1Carolyn Ehrlich A B , Elizabeth Kendall A and Heidi Muenchberger A
A Centre of National Research on Disability and Rehabilitation, Griffith Health Institute, Griffith University, University Drive, Meadowbrook, Qld 4131, Australia.
B Corresponding author. Email: firstname.lastname@example.org
Australian Journal of Primary Health 17(1) 72-78 https://doi.org/10.1071/PY10053
Submitted: 30 August 2010 Accepted: 4 January 2011 Published: 16 March 2011
This paper explores issues related to the types of support that practice nurses require to engage in care coordination for people with chronic conditions. A sample of practice nurses and general practitioners participated in a focus group discussion to identify their perspectives on the role of practice nurses as providers of care coordination, the specific tasks that might be conducted and the types of support that might be required. The data were analysed using thematic analysis. The findings suggested there was considerable confusion about care coordination and a lack of conceptual clarity. Nevertheless, nurses were committed to engaging in activities that would promote care coordination. Four main themes emerged that indicated the importance of a developmental and well-supported implementation process. These themes included the need for cultural change within the whole practice, increased capacity to develop trusted and tested partnerships, appropriate role definition and a full understanding of the financial models that could support care coordination. Practice nurses clearly have a role in care coordination, but models of care coordination need to be localised and contextualised within specific GP practices. Cultural change will, in many instances, be critical to the development of localised programs. Broad supportive structures, including ongoing mentorship and administrative assistance (particularly with financial and procedural aspects of care coordination) will be required when implementing programs that enhance roles for practice nurses.
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