A Closer Look at Care Coordination

As the search for a more efficient healthcare system barrels on, care coordination has emerged as a frontrunner among tools that shape the future—the goal being to boost patient satisfaction while helping to curb costs. And because you’re likely to encounter the concept quite a bit while the system remains in flux, we’re going to take a moment to give it a once-over.

What is care coordination?

In a nutshell:

“Care coordination in the primary care practice that involves deliberately organizing patient care activities and sharing information among all of the participants concerned with a patient’s care to achieve safer and more effective care. This means that the patient’s needs and preferences are known and communicated at the right time to the right people, and that this information is used to guide the delivery of safe, appropriate and effective care.”

The vision, in other words, is a healthcare system that operates like a well-oiled machine. What should we do first? Drastically reduce the gaps between the system’s many branches, such as urgent care clinics and specialty services, and in turn provide a higher quality experience for the patient and more efficiencies for the healthcare organization.

What care coordination entails

As it turns out, care coordination entails a lot. That said, here are a few overarching structural changes that care coordination might involve:

• Training staff to coordinate referrals and transitions of care based upon an assessment of each patient’s clinical, insurance and logistical needs, identifying those with barriers and following up with patients who have shifted hands. To lead in this area of nursing, you may want to consider an MSN in care coordination to formalize the skills you need to perform in this complex role.
• Developing and implementing a system to ensure that specialists understand patient referrals and have access to all the information they need, and that primary care physicians are aware of what happened during a referral visit.
• Following up with patients after an emergency room visit or hospital discharge and clearly communicating results to patients and their families.
• Tracking and supporting patients as they seek healthcare services outside of primary care.
• Assessing internal needs to identify key specialists or community groups with which to connect.

The big takeaways here? Internal and external communication among care services, a commitment to follow-through and a level of systemization are great qualities to have for this type of career move.