Facilitating continuity of care. The role of the patient care coordinator

Area of Science:

• Pediatric Cardiology
• Healthcare Coordination
• Patient Care Management

Background:

• Continuity of care is crucial for children with cardiac conditions.
• Effective post-discharge management is vital for pediatric cardiovascular patients.
• Fragmented care can negatively impact outcomes for these children.

Purpose of the Study:

• To describe the role of the Pediatric Care Coordinator (PCC) in ensuring continuity of care for children with cardiac disease.
• To highlight the PCC's function in coordinating post-discharge services.
• To emphasize the PCC's role as a liaison among various stakeholders.

Main Methods:

• The PCC collaborates with the interdisciplinary healthcare team.
• The PCC identifies and communicates community-based post-discharge care options.
• The PCC provides patient-specific information to community providers and educates payers.

Main Results:

• The PCC acts as a central resource, linking patients, families, healthcare teams, community providers, and payers.
• Coordination of services is facilitated through the PCC's role.
• Information exchange regarding patient needs is improved.

Conclusions:

• The Pediatric Care Coordinator (PCC) is essential for maintaining continuity of care for pediatric cardiovascular patients.
• The PCC's role as a liaison improves care transitions and resource identification.
• Effective coordination enhances the delivery of necessary post-discharge care.