Care Coordination and the Health Workforce
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Care coordination is the process of coordinating health services provided to a patient from different health care providers and health systems, with the goal of ensuring the best possible care for the patient. The Agency for Healthcare Research and Quality also reports that effective communication and information exchange are central to effective care coordination. Specific goals of coordinated care include the following:
- Minimize the number of hospitalizations
- Improve health status
- Reduce health care costs
- Identify the medical, functional, emotional, and social needs of each patient
- Meet those needs through integration of medical services and education
- Monitor patients effectively for signs of problems.
This wide range of objectives places demands on health workforce. Effective care coordination necessitates strategies to make health care systems more responsive to the particular needs of each patient. The success of these strategies can depend to a large degree on the following:
- Team-based care: in which health care professionals collaborate across multiple disciplines and integrate their expertise and methodology.
Interprofessional training: in which health professions students and practitioners from different disciplines learn the skills and methods to work together so they can provide team-based care successfully.
- Effective communication: skills and methods which ensure clarity between a given patient’s various providers, and in turn, between those providers and their patient.
Care coordination is particularly important for patients with complex, multifaceted needs. In recent years the concept of a “medical home” has increased in prominence. According to the American Academy of Pediatrics, a medical home is “a model of delivering primary care that is accessible, continuous, comprehensive, family-centered, coordinated, compassionate, and culturally effective.” A medical home transforms the traditional doctor's office into a central area to organize and coordinate a patient's health care, based on that patient's needs and priorities. At the base is an ongoing partnership between the patient and a specially-trained primary care physician, who helps to assemble a team of specialists and other health care providers, as needed. The patient decides who is on their team, and the primary care physician makes sure they are working together to meet all of the patient's needs.
Page last updated April 18, 2012