Coordination of Care: Strategies, Lessons, & Implications
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Background: Care Coordination was identified as a fundamental process that can decrease care fragmentation. IOM and ANA identified Registered Nurses as capable of spearheading care coordination initiatives that will close the gap. It is well established that professional nurse environments positively affects nurse and patient outcomes, or conversely is a barrier when not present. A professional practice environment serves to facilitate care coordination (Duva, 2010).
Expanding this work, using Donebedian's SPO Framework, this quality improvement project examined the relationship between the care coordinators work environment and the work processes of care coordination.
Methods: A descriptive correlational design was used to survey 329 RNs from Veterans Health Administration Geriatric and Extended Care Line using Lake„s PES-NWI scale and Gittell's RCI instrument. Analyses included descriptive statistics, correlations, and multiple regression analysis (Stepwise Method).
Findings: Moderately positive significant correlations were found between the PES-NWI and RCI activities (r = .30, p< .001). Nurse participation in hospital affairs, staffing and resources adequacy, and Collegial Nurse-Physician relationship were significant predictors on overall perceptions of RCI, 24.8% of variance R2.248; F (3,110) = 12.11, p<0.001.
Discussion/Implications: Findings support the linkage between the RN, the practice environment, and activities of care coordination. Integrated service delivery systems require a RN workforce that is ready, trained, functioning at their highest level of performance, and available to meet the current and future needs of health care delivery. Findings provide an actionable profile of the RN Care Coordinator, their practice environment, and strategies to improve both. Future study is required.
|Type||DNP Capstone Project|
|Review Type||None: Degree-based Submission|
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