Care coordination for chronic and complex health conditions: An experienced based co-design study engaging consumer and clinician groups for service improvement


Autoři: Liza Heslop aff001;  Kathryn Cranwell aff002;  Trish Burton aff003
Působiště autorů: Institute for Sport and Health, College of Health and Biomedicine, Victoria University, Melbourne, Victoria, Australia aff001;  Community Integration, Allied Health & Service Planning, Western Health, Sunshine, Victoria, Australia aff002;  Nursing and Midwifery, James Cook University, Cairns, Queensland, Australia aff003
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224380

Souhrn

Background

Evidence shows that engaging consumers and clinicians in development of health services creates a more responsive, integrated service that better meets the needs of consumers and the community of practice it serves. Further, consumer and clinician participation in service development processes can boost confidence and motivation levels in organisational employees and help foster clinical accountability.

Objective

To see where consumers’ care experiences could be improved by better understanding where care coordination organisational systems needed improvement.

Methods

Experienced based co-design informed an investigation of consumer and clinician experiences of a care coordination service and involved the sharing of those experiences across service employees in a series of iterative and feedback loops over eighteen months (July 2012-January 2014). Formal participants included care coordination clinicians (n = 13) and consumers. Data from formal participants were collected during September-December 2012, consisting of consumer video-recorded and clinician audio-recorded interviews. Interview transcriptions were analysed to identify service “touch points”, being emotionally significant events related to key service aspects that connect or disconnect consumers and/or clinicians.

Results

Results revealed that consumers highly valued the transdisciplinary skill base of the care coordination workforce, though service improvements were needed for transition support, quality discharge planning and conveying better understandings of care coordination activity both internally and externally.

Conclusion

Incorporating consumer and clinician view-points about their experiences, including the production of a DVD, facilitated conversations across the entire service about care coordination provision and provided a catalyst for design improvement that may otherwise have been difficult to achieve. Some changes to the service were made such as improved client complaints processes, new roles for the care coordination service, and enlisting clinical staff to undertake motivational interviewing training to promote greater consumer self-management capacity. In this study, the user experience was given a platform within a larger healthcare workforce capability development project.

Klíčová slova:

Emotions – Employment – Health services research – Inpatients – Medical doctors – Qualitative studies – Steering – Touch


Zdroje

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Článek vyšel v časopise

PLOS One


2019 Číslo 10