Care coordination across healthcare systems: development of a research agenda, implications for practice, and recommendations for policy based on a modified Delphi panel

ObjectiveFor 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 f...

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Published inBMJ open Vol. 13; no. 5; p. e060232
Main Authors Hempel, Susanne, Ganz, David, Saluja, Sonali, Bolshakova, Maria, Kim, Timothy, Turvey, Carolyn, Cordasco, Kristina, Basu, Aashna, Page, Tonya, Mahmood, Reshma, Motala, Aneesa, Barnard, Jenny, Wong, Michelle, Fu, Ning, Miake-Lye, Isomi M
Format Journal Article
LanguageEnglish
Published England British Medical Journal Publishing Group 17.05.2023
BMJ Publishing Group LTD
BMJ Publishing Group
SeriesOriginal research
Subjects
Communication
Consensus
Continuity of care
Delivery of Health Care, Integrated
Delphi Technique
Feedback
Health care delivery
health policy
Health services
health services administration & management
Health Services Research
Humans
Integrated delivery systems
Literature reviews
Medical personnel
Meetings
Palliative care
Patients
Policy
Primary care
Professionals
quality in health care
Stakeholders
Surveys and Questionnaires
quality in health care
health policy
health services administration & management
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Abstract ObjectiveFor 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.DesignThe modified Delphi approach convened a 2-day stakeholder panel with moderated virtual discussions, preceded and followed by online surveys.SettingThe 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.ParticipantsThe 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 measuresThe study planned to formulate a research agenda, implications for practice and recommendations for policy.ResultsFor 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.ConclusionsRecommendations from the stakeholder panel created an agenda to foster further research, practice and policy innovations in cross-system care coordination.
AbstractList 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. The modified Delphi approach convened a 2-day stakeholder panel with moderated virtual discussions, preceded and followed by online surveys. 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. 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. The study planned to formulate a research agenda, implications for practice and recommendations for policy. 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. Recommendations from the stakeholder panel created an agenda to foster further research, practice and policy innovations in cross-system care coordination.
ObjectiveFor 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.DesignThe modified Delphi approach convened a 2-day stakeholder panel with moderated virtual discussions, preceded and followed by online surveys.SettingThe 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.ParticipantsThe 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 measuresThe study planned to formulate a research agenda, implications for practice and recommendations for policy.ResultsFor 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.ConclusionsRecommendations from the stakeholder panel created an agenda to foster further research, practice and policy innovations in cross-system care coordination.
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.
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.
Author Saluja, Sonali
Motala, Aneesa
Ganz, David
Turvey, Carolyn
Mahmood, Reshma
Miake-Lye, Isomi M
Cordasco, Kristina
Bolshakova, Maria
Wong, Michelle
Page, Tonya
Barnard, Jenny
Basu, Aashna
Kim, Timothy
Hempel, Susanne
Fu, Ning
AuthorAffiliation 3 Department of Medicine , David Geffen School of Medicine at the University of California at Los Angeles , Los Angeles , California , USA
1 Southern California Evidence Review Center , University of Southern California , Los Angeles , California , USA
8 Rural Health Resource Center , Iowa City Veterans Affairs Healthcare System , Iowa City , Iowa , USA
14 VA West Los Angeles Evidence-based Synthesis Program , VA Greater Los Angeles Healthcare System , Los Angeles , California , USA
15 Health Policy and Management , UCLA Fielding School of Public Health , Los Angeles , California , USA
12 Santa Maria and San Luis Obispo Community Outpatient Clinics , VA Greater Los Angeles Healthcare System , Los Angeles , California , USA
5 Keck School of Medicine , University of Southern California , Los Angeles , California , USA
6 Center for Access and Delivery Research and Evaluation , Iowa City Veterans Affairs Healthcare System , Iowa City , Iowa , USA
7 Department of Psychiatry , Roy J. and Lucille A.
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/37197809$$D View this record in MEDLINE/PubMed
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CitedBy_id crossref_primary_10_1111_dom_15476
crossref_primary_10_1016_j_sleh_2024_01_007
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Issue 5
Keywords quality in health care
health policy
health services administration & management
Language English
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Snippet ObjectiveFor large, integrated healthcare delivery systems, coordinating patient care across delivery systems with providers external to the system presents...
For large, integrated healthcare delivery systems, coordinating patient care across delivery systems with providers external to the system presents challenges....
Objective For large, integrated healthcare delivery systems, coordinating patient care across delivery systems with providers external to the system presents...
OBJECTIVEFor large, integrated healthcare delivery systems, coordinating patient care across delivery systems with providers external to the system presents...
Objective For large, integrated healthcare delivery systems, coordinating patient care across delivery systems with providers external to the system presents...
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StartPage e060232
SubjectTerms Communication
Consensus
Continuity of care
Delivery of Health Care, Integrated
Delphi Technique
Feedback
Health care delivery
health policy
Health services
health services administration & management
Health Services Research
Humans
Integrated delivery systems
Literature reviews
Medical personnel
Meetings
Palliative care
Patients
Policy
Primary care
Professionals
quality in health care
Stakeholders
Surveys and Questionnaires
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Title Care coordination across healthcare systems: development of a research agenda, implications for practice, and recommendations for policy based on a modified Delphi panel
URI http://dx.doi.org/10.1136/bmjopen-2021-060232
https://www.ncbi.nlm.nih.gov/pubmed/37197809
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Volume 13
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