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  11. How External And Agency Characteristics Are Related To Coordination In Homecare - Findings Of The National Multicenter, Cross-sectional Spotnat Study

How external and agency characteristics are related to coordination in homecare - findings of the national multicenter, cross-sectional SPOTnat study

Nathalie Möckli1, Michael Simon1, Kris Denhaerynck1

  • 1Department of Public Health, Institute of Nursing Science, Bernoullistrasse 28, CH-4056, Basel, Switzerland.

BMC Health Services Research
|March 23, 2024

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View abstract on PubMed

Summary
This summary is machine-generated.

Effective care coordination in homecare relies on implicit mechanisms like trust and role clarity, alongside explicit communication strategies. Strengthening these implicit factors is key to improving patient care, even with staffing challenges.

Area of Science:

  • Healthcare Management
  • Nursing Research
  • Health Services Research

Background:

  • Homecare services involve multiple providers, necessitating effective care coordination.
  • Existing research on care coordination in homecare is limited, creating knowledge gaps.
  • This study investigates factors influencing care coordination within the Swiss homecare sector.

Purpose of the Study:

  • To explore the relationship between external factors (financial, regulatory) and homecare agency characteristics (work environment, workforce, client attributes) with care coordination.
  • To identify key determinants of care coordination in the homecare setting.

Main Methods:

  • A national multicentre, cross-sectional study in the Swiss homecare setting.
  • Data collected via agency and employee questionnaires from 71 homecare agencies (1450 employees).
Keywords:
Coordination“Communication”[Mesh]“Delivery of health care”[Mesh]“Government regulation”[Mesh]

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  • Analysis utilized a novel care coordination framework (COORA) and multilevel regression models.

    • Main Results:

    • Explicit coordination (communication and information exchange) and four implicit mechanisms (knowledge of health system, role clarity, mutual respect/trust, accountability/predictability/common perspective) were positively associated with perceived coordination.
    • Agency characteristics and external factors influenced coordination indirectly through coordination processes.
    • Implicit coordination mechanisms significantly impacted employee-perceived care coordination.

    Conclusions:

    • Implicit coordination mechanisms are crucial for enhancing team communication and require further investigation.
    • Developing strategies to strengthen implicit mechanisms, with full care team involvement, is vital for creating supportive explicit structures.
    • Effective coordination processes can mitigate challenges related to staffing, workload, and overtime.
    “Health services Research”[Mesh]
    “Healthcare financing”[Mesh]
    “Home care services”[Mesh]
    “Nursing administration research”[Mesh]
    “Quality of health care”[Mesh]