Coordinating Complex Care: A General Practice Perspective

Abstract

Aims & rationale/Objectives The purpose of this study was to examine the concept of care coordination within general practice settings prior to the development and implementation of a coordinated care program. Coordinated care in primary health care relies heavily on complicated concepts such as partnerships, networking, collaboration, knowledge transfer, person-centered practice and self-management support (Ehrlich et al. 2009). However, there is little evidence regarding the way in which care coordination strategies can be applied within a general practice context. Methods Thirteen participants in three focus groups were asked to respond to questions about the occurrence of specific coordinated care activities within their practice settings. Focus group discussions were recorded and transcribed. Thematic analysis of the data was conducted by two independent researchers. Principal findings Five major issues arose from the focus groups that would require attention prior to the implementation of a care coordination intervention based in general practice. These themes were a) conceptual confusion, b) internal and external partnerships, c) cultural change, d) financial models for a business context, and e) professional definition, development and recognition. Implications General practices must be supported to develop a localised and appropriate model of care coordination. However, creating opportunities for cultural change is critical, given the degree of confusion that currently exists in general practice and the divergent views of practice nurses and general practitioners regarding coordinated care.