Key factors in patient-centered care coordination in ambulatory care: Nurse care coordinators' perspectives

Applied Nursing Research

Volumn 28, Issue 1, 2015, Pages 18-24

  Vanderboom, Catherine E ^a   Thackeray, Nona L ^a   Rhudy, Lori M ^b  

^a MAYO CLINIC   (United States)

^b UNIVERSITY OF MINNESOTA   (United States)

Author keywords

Chronic illness; Nurse care coordination; Nurse perspectives; Qualitative research

Indexed keywords

AMBULATORY CARE; HUMAN; NURSING CARE; PATIENT CARE; PROCEDURES; VERY ELDERLY;

AGED, 80 AND OVER; AMBULATORY CARE; HUMANS; NURSING CARE; PATIENT-CENTERED CARE;

EID: 84921559566     PISSN: 08971897     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.apnr.2014.03.004     Document Type: Article

References (40)

1. Agency for Healthcare Research, Quality. Medical Expenditure Panel Survey Retrieved June 19, 2012, from. http://meps.ahrq.gov/mepsweb/about_meps/survey_back.jsp?prfricon=yes.
2. Aliotta S.L., Grieve K., Giddens J.F., Dunbar L., Groves C., Frey K., et al. Guided care: A new frontier for adults with chronic conditions. Professional Case Management 2008, 13(3):151-158. (quiz 159-160).
3. Arend J., Tsang-Quinn J., Levine C., Thomas D. The patient-centered medical home: History, components, and review of the evidence. Mount Sinai Journal of Medicine 2012, 79(4):433-450. 10.1002/msj.21326.
4. Bodenheimer T., Lorig K., Holman H., Grumbach K. Patient self-management of chronic disease in primary care. JAMA 2002, 288(19):2469-2475.
5. Boult C., Reider L., Frey K., Leff B., Boyd C.M., Wolff J.L., et al. Early effects of "guided care" on the quality of health care for multimorbid older persons: A cluster-randomized controlled trial. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences 2008, 63(3):321-327.
6. Boult C., Reider L., Leff B., Frick K.D., Boyd C.M., Wolff J.L., et al. The effect of guided care teams on the use of health services: Results from a cluster-randomized controlled trial. Archives of Internal Medicine 2011, 171(5):460-466.
7. Boyd C.M., Boult C., Shadmi E., Leff B., Brager R., Dunbar L., et al. Guided care for multimorbid older adults. Gerontologist 2007, 47(5):697-704.
8. Boyd C.M., Reider L., Frey K., Scharfstein D., Leff B., Wolff J., et al. The effects of guided care on the perceived quality of health care for multi-morbid older persons: 18-month outcomes from a cluster-randomized controlled trial. Journal of General Internal Medicine 2009, 25(3):235-242.
9. Centers for Disease Control and Prevention - Office of Surveillance, Epidemiology, and Laboratory Services Skin Cancer Module: Practice Exercises Retrieved November 8, 2013, from. http://www.cdc.gov/excite/skincancer/mod13.htm.
10. DiMatteo M.R. Social support and patient adherence to medical treatment: A meta-analysis. Health Psychology 2004, 23(2):207-218. 10.1037/0278-6133.23.2.207.
11. Gallant M.P. The influence of social support on chronic illness self-management: A review and directions for research. Health Education & Behavior 2003, 30:170-195. 10.1177/1090198102251030.
12. Gottlieb L.N., Gottlieb B. The developmental/health framework within the McGill Model of Nursing: "Laws of nature" guiding whole person care. ANS. Advances in Nursing Science 2007, 30(1):E43-E57.
13. Graneheim U.H., Lundman B. Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Education Today 2004, 24(2):105-112.
14. Institute of Medicine. Crossing the quality chasm: A new health care system for the 21st century 2001, National Academy Press, Washington, DC.
15. Institute of Medicine Committee on Communication for Behavior Change in the 1st Century Improving the Health of Diverse Populations. Speaking of health: Assessing health communication strategies for diverse populations 2002, National Academies Press, Washington, D.C.
16. Jackson G.L., Powers B.J., Chatterjee R., Prvu Bettger J., Kemper A.R., Hasselblad V., et al. The patient-centered medical home: A systematic review. Annals of Internal Medicine 2013, 158(3):169-178. 10.7326/0003-4819-158-3-201302050-00579.
17. Kansagara D., Englander H., Salanitro A., Kagen D., Theobald C., Freeman M., et al. Risk prediction models for hospital readmission: A systematic review. JAMA 2011, 306(15):1688-1698.
18. Krippendorff K. Content analysis: An introduction to its methodology 2004, Sage, Thousand Oaks, Calif.
19. Krueger R.A., Casey M.A. Focus groups: A practical guide for applied research 2009, SAGE, London.
20. Lauver D.R., Ward S.E., Heidrich S.M., Keller M.L., Bowers B.J., Brennan P.F., et al. Patient-centered interventions. Research in Nursing & Health 2002, 25(4):246-255.
21. Leff B., Reider L., Frick K., Scharfstein D.O., Boyd C.M., Frey K., et al. Guided care and the cost of complex healthcare: A preliminary report. American Journal of Managed Care 2009, 15(8):555-559.
22. Lorig K., Ritter P.L., Villa F., Piette J.D. Spanish diabetes self-management with and without automated telephone reinforcement: Two randomized trials. Diabetes Care 2008, 31(3):408-414. 10.2337/dc07-1313.
23. Lorig K.R., Sobel D.S., Ritter P.L., Laurent D., Hobbs M. Effect of a self-management program on patients with chronic disease. Effective Clinical Practice 2001, 4(6):256-262.
24. Marek K.D., Adams S.J., Stetzer F., Popejoy L., Rantz M. The relationship of community-based nurse care coordination to costs in the Medicare and Medicaid programs. Research in Nursing & Health 2010, 33:235-242. 10.1002/nur.20378.
25. Marek K.D., Popejoy L., Petroski G., Mehr D., Rantz M., Lin W. Clinical outcomes of aging in place. Nursing Research 2005, 54(3):202-211.
26. Marek K.D., Rantz M.J. Aging in place: A new model for long-term care. Nursing Administration Quarterly 2000, 24(3):1-11.
27. Mead N., Bower P. Patient-centredness: A conceptual framework and review of the empirical literature. Social Science and Medicine 2000, 51(7):1087-1110.
28. Meyer J., Smith B.M. Chronic disease management: Evidence of predictable savings 2008, Health Management Associates.
29. National Quality Forum. Care coordination endorsement maintenance 2012: Phases 1 and 2 2012.
30. National Quality Forum. Multiple chronic conditions measurement framework Retrieved November 8, 2013, from. http://www.qualityforum.org/Publications/2012/05/MCC_Measurement_Framework_Final_Report.aspx.
31. Olsen J.M., Nesbitt B.J. Health coaching to improve healthy lifestyle behaviors: An integrative review. American Journal of Health Promotion 2010, 25(1):e1-e12. 10.4278/ajhp.090313-LIT-101.
32. Reid R.J., MacWilliam L., Verhulst L., Roos N., Atkinson M. Performance of the ACG case-mix system in two Canadian provinces. Medical Care 2001, 39(1):86-99.
33. Reid R.J., Roos N.P., MacWilliam L., Frohlich N., Black C. Assessing population health care need using a claims-based ACG morbidity measure: A validation analysis in the province of Manitoba. Health Services Research 2002, 37(5):1345-1364.
34. Ryan P., Sawin K.J. The individual and family self-management theory: Background and perspectives on context, process, and outcomes. Nursing Outlook 2009, 57(4):217-225. (e216). 10.1016/j.outlook.2008.10.004.
35. Shier G., Ginsburg M., Howell J., Volland P., Golden R. Strong social support services, such as transportation and help for caregivers, can lead to lower health care use and costs. Health Affairs 2013, 32(3):544-551. 10.1377/hlthaff.2012.0170.
36. Sylvia M.L., Griswold M., Dunbar L., Boyd C.M., Park M., Boult C. Guided care: Cost and utilization outcomes in a pilot study. Disease Management 2008, 11(1):29-36.
37. Taylor C.B., Miller N.H., Reilly K.R., Greenwald G., Cunning D., Deeter A., et al. Evaluation of a nurse-care management system to improve outcomes in patients with complicated diabetes. Diabetes Care 2003, 26(4):1058-1063.
38. Tinetti M.E., Fried T.R., Boyd C.M. Designing health care for the most common chronic condition-multimorbidity. JAMA 2012, 307(23):2493-2494.
39. Wagner E.H., Austin B.T., Davis C., Hindmarsh M., Schaefer J., Bonomi A. Improving chronic illness care: Translating evidence into action. Health Affairs 2001, 20(6):64-78.
40. Wagner E.H., Bennett S.M., Austin B.T., Greene S.M., Schaefer J.K., Vonkorff M. Finding common ground: Patient-centeredness and evidence-based chronic illness care. Journal of Alternative and Complementary Medicine 2005, 11(Suppl 1):S7-S15.