Care Coordination Tough to Define, Measure
We have many, many definitions of care coordination, and the one that we use most commonly from the Agency for Healthcare Research and Quality, is a combination of [dozens of] definitions. So [it's] really channeling from a rather abstract concept to what does this mean for patients and families, how does it impact outcomes? Measurement really is the bridge for that and thus becomes really important.
HLM: What kinds of feedback and additions did you make to the framework from talking with these nurses and nurse leaders that you consulted with?
Dailey: We identified missing concepts or domains and sub-domains… that made it a richer framework to better capture nurses contributions. One area is transition of care, that's a subset of care coordination, so that's a very rich area to capture nurses' contributions to care coordination.
And also there's a related concept… care coordination is very much related to another national quality strategy priority, which is person- and family-centered care, so identifying patient-centered goals. Many of the things cross over, they're related by different concepts.
Lamb: It's fairly common to have communication as one of the domains and there's lots of work going on in the area of capturing how well we're communicating across providers and across settings.
The pieces that the new framework and certainly the work that the National; Quality Forum is doing to look at measurement gaps, is now bringing in the areas that Maureen is talking to: How are patients and families involved in care coordination? What role do they play? How are they becoming part of the decision making? Which is all part of patient-centered care.
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