The ongoing relationship between the patient and the provider is a cornerstone of primary care. The healthcare system oftentimes can be a confusing tangle of complicated interactions for patients.
The PCMH model encourages practices to guide patients beyond the practice setting. This can be done through cooperative alliances with essential healthcare services that offer a complete range of needs for a given patient population.
Care coordination involves developing structured relationships with individuals and facilities outside of the primary care setting that are necessary to provide comprehensive care. A need for care beyond the scope of the primary care office occurs frequently, and it is important to include this care in the overall management of the patient.
Care coordination expands the definition of team to include all providers, locations and resources necessary to meet the patient’s healthcare needs. This extended care team can include specialists, hospital facilities, home health facilities, long-term care facilities, durable medical equipment vendors, public health entities, pharmacists, social workers, psychologists, physical therapists and any other healthcare entity that affects the patient’s healthcare.
Effective care coordination provides for an understanding of each team member’s role and responsibility at the time of the patient interaction and a clearly defined information flow between team members. Each team member has accurate current information for every patient at each encounter.
Topics covered in this book include:
- Obstacles to effective care coordination
- The care coordination process
- Coordination with hospitals, emergency rooms, and urgent care facilities
- Coordination of care provided by specialist physicians
- Planning for effective care coordination
- Care coordinator role
- And more than 20 templates are included for your immediate use
2010, 82 pp., ISBN 978-1-56829-383-7