Care coordination across healthcare systems: development of a research agenda, implications for practice, and recommendations for policy based on a modified Delphi panel
Objective For large, integrated healthcare delivery systems, coordinating patient care across delivery systems with providers external to the system presents challenges. We explored the domains and requirements for care coordination by professionals across healthcare systems and developed an agenda...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-05-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/5/e060232.full |
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| author | Aneesa Motala Susanne Hempel Michelle Wong Maria Bolshakova Ning Fu David Ganz Sonali Saluja Timothy Kim Carolyn Turvey Kristina Cordasco Aashna Basu Tonya Page Reshma Mahmood Jenny Barnard Isomi M Miake-Lye |
| author_facet | Aneesa Motala Susanne Hempel Michelle Wong Maria Bolshakova Ning Fu David Ganz Sonali Saluja Timothy Kim Carolyn Turvey Kristina Cordasco Aashna Basu Tonya Page Reshma Mahmood Jenny Barnard Isomi M Miake-Lye |
| author_sort | Aneesa Motala |
| collection | DOAJ |
| description | Objective For large, integrated healthcare delivery systems, coordinating patient care across delivery systems with providers external to the system presents challenges. We explored the domains and requirements for care coordination by professionals across healthcare systems and developed an agenda for research, practice and policy.Design The modified Delphi approach convened a 2-day stakeholder panel with moderated virtual discussions, preceded and followed by online surveys.Setting The work addresses care coordination across healthcare systems. We introduced common care scenarios and differentiated recommendations for a large (main) healthcare organisation and external healthcare professionals that contribute additional care.Participants The panel composition included health service providers, decision makers, patients and care community, and researchers. Discussions were informed by a rapid review of tested approaches to fostering collaboration, facilitating care coordination and improving communication across healthcare systems.Outcome measures The study planned to formulate a research agenda, implications for practice and recommendations for policy.Results For research recommendations, we found consensus for developing measures of shared care, exploring healthcare professionals’ needs in different care scenarios and evaluating patient experiences. Agreed practice recommendations included educating external professionals about issues specific to the patients in the main healthcare system, educating professionals within the main healthcare system about the roles and responsibilities of all involved parties, and helping patients better understand the pros and cons of within-system and out-of-system care. Policy recommendations included supporting time for professionals with high overlap in patients to engage regularly and sustaining support for care coordination for high-need patients.Conclusions Recommendations from the stakeholder panel created an agenda to foster further research, practice and policy innovations in cross-system care coordination. |
| format | Article |
| id | doaj-art-8f9c0f9027814bc2a2221af137f00e3e |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2023-05-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-8f9c0f9027814bc2a2221af137f00e3e2025-02-09T15:55:10ZengBMJ Publishing GroupBMJ Open2044-60552023-05-0113510.1136/bmjopen-2021-060232Care coordination across healthcare systems: development of a research agenda, implications for practice, and recommendations for policy based on a modified Delphi panelAneesa Motala0Susanne Hempel1Michelle Wong2Maria Bolshakova3Ning Fu4David Ganz5Sonali Saluja6Timothy Kim7Carolyn Turvey8Kristina Cordasco9Aashna Basu10Tonya Page11Reshma Mahmood12Jenny Barnard13Isomi M Miake-Lye14University of Southern California, Los Angeles, California, USASouthern California Evidence Review Center, University of Southern California, Los Angeles, California, USA4 Division of Pulmonology, Chris Hani Baragwanath Hospital, Johannesburg, South AfricaSouthern California Evidence Review Center, University of Southern California, Los Angeles, California, USASouthern California Evidence Review Center, University of Southern California, Los Angeles, California, USADepartment of Medicine, David Geffen School of Medicine at the University of California at Los Angeles, Los Angeles, California, USAGehr Family Center for Health Systems Science and Innovation, University of Southern California, Los Angeles, California, USAKeck School of Medicine, University of Southern California, Los Angeles, California, USACenter for Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Healthcare System, Iowa City, Iowa, USAVA Greater Los Angeles Healthcare System, Los Angeles, California, USADepartment of Medicine, David Geffen School of Medicine at the University of California at Los Angeles, Los Angeles, California, USAOffice of Community, Clinical Integration & Field Support, Veteran Affairs Central Office, Kentucky City, Kentucky, USASanta Maria and San Luis Obispo Community Outpatient Clinics, VA Greater Los Angeles Healthcare System, Los Angeles, California, USAVA Greater Los Angeles Healthcare System, Los Angeles, California, USAVA West Los Angeles Evidence-based Synthesis Program, VA Greater Los Angeles Healthcare System, Los Angeles, California, USAObjective For large, integrated healthcare delivery systems, coordinating patient care across delivery systems with providers external to the system presents challenges. We explored the domains and requirements for care coordination by professionals across healthcare systems and developed an agenda for research, practice and policy.Design The modified Delphi approach convened a 2-day stakeholder panel with moderated virtual discussions, preceded and followed by online surveys.Setting The work addresses care coordination across healthcare systems. We introduced common care scenarios and differentiated recommendations for a large (main) healthcare organisation and external healthcare professionals that contribute additional care.Participants The panel composition included health service providers, decision makers, patients and care community, and researchers. Discussions were informed by a rapid review of tested approaches to fostering collaboration, facilitating care coordination and improving communication across healthcare systems.Outcome measures The study planned to formulate a research agenda, implications for practice and recommendations for policy.Results For research recommendations, we found consensus for developing measures of shared care, exploring healthcare professionals’ needs in different care scenarios and evaluating patient experiences. Agreed practice recommendations included educating external professionals about issues specific to the patients in the main healthcare system, educating professionals within the main healthcare system about the roles and responsibilities of all involved parties, and helping patients better understand the pros and cons of within-system and out-of-system care. Policy recommendations included supporting time for professionals with high overlap in patients to engage regularly and sustaining support for care coordination for high-need patients.Conclusions Recommendations from the stakeholder panel created an agenda to foster further research, practice and policy innovations in cross-system care coordination.https://bmjopen.bmj.com/content/13/5/e060232.full |
| spellingShingle | Aneesa Motala Susanne Hempel Michelle Wong Maria Bolshakova Ning Fu David Ganz Sonali Saluja Timothy Kim Carolyn Turvey Kristina Cordasco Aashna Basu Tonya Page Reshma Mahmood Jenny Barnard Isomi M Miake-Lye Care coordination across healthcare systems: development of a research agenda, implications for practice, and recommendations for policy based on a modified Delphi panel BMJ Open |
| title | Care coordination across healthcare systems: development of a research agenda, implications for practice, and recommendations for policy based on a modified Delphi panel |
| title_full | Care coordination across healthcare systems: development of a research agenda, implications for practice, and recommendations for policy based on a modified Delphi panel |
| title_fullStr | Care coordination across healthcare systems: development of a research agenda, implications for practice, and recommendations for policy based on a modified Delphi panel |
| title_full_unstemmed | Care coordination across healthcare systems: development of a research agenda, implications for practice, and recommendations for policy based on a modified Delphi panel |
| title_short | Care coordination across healthcare systems: development of a research agenda, implications for practice, and recommendations for policy based on a modified Delphi panel |
| title_sort | care coordination across healthcare systems development of a research agenda implications for practice and recommendations for policy based on a modified delphi panel |
| url | https://bmjopen.bmj.com/content/13/5/e060232.full |
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