Implementing Care Coordination in General practice: Embedding New Methods

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Kendall, Elizabeth

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St John, Winsome

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2011
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Abstract

In Australia, the health care system is complex, constantly changing and comprised of multiple layers. Within this complex system, service fragmentation, care segmentation, and confusion about access to and provision of health care services, is likely to be the usual experience of both consumers and providers of health care. Chronic condition care coordination is frequently touted as one solution to these problems, but its implementation has been less successful. Given that access to the health care system most frequently originates in general practice, implementation within this context is particularly important. However, implementing chronic condition care coordination within general practice is not likely to be simple because a complete reorientation of general practice will be required, from an acute care focus towards the ongoing management of chronic conditions. Nurses (RNs) who work in general practice provide an opportunity for achieving this type of reorientation, but the sustainability of any changes will be dependent on the way in which practices become routinely embedded in the work of general practice. This research examines the implementation of RN-provided chronic condition care coordination in general practice. According to Normalization Process Theory (NPT) (May & Finch, 2009), the extent to which any new practice or innovation becomes embedded in usual practice is dependent on the extent to which its components are workable within the context and are capable of being integrated into existing ways of operating. Thus, the most appropriate theoretical framework to apply to the interpretation of this research is NPT.

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Thesis (PhD Doctorate)

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Doctor of Philosophy (PhD)

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School of Human Services and Social Work

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The author owns the copyright in this thesis, unless stated otherwise.

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Public

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Subject

Health care system

Chronic condition care coordination

Nursing in Australia

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