Abstract
Background
Strategies to improve care coordination between primary and hospital care do not always
have the desired results. This is partly due to incomplete understanding of the key concepts of
care coordination. An in-depth analysis of existing theoretical frameworks for the study of
care coordination identified 14 interrelated key concepts. In another study, these 14 key
concepts were further explored in patients? experiences. Additionally, ?patient
characteristics? was identified as a new key concept in patients? experiences and the
previously identified key concept ?quality of relationship? between healthcare professionals
was extended to ?quality of relationship? with the patient. Together, these 15 interrelated key
concepts resulted in a new theoretical framework. The present study aimed at improving our
understanding of the 15 previously identified key concepts and to explore potentially
previous unidentified key concepts and the links between these by exploring how healthcare
professionals experience care coordination.
Methods
A qualitative design was used. Six focus groups were conducted including primary healthcare
professionals involved in the care of patients who had breast cancer surgery at three hospitals
in Belgium. Data were analyzed using constant comparative analysis.
Results
All 15 previously identified key concepts of care coordination were further explored in
healthcare professionals? experiences. Links between these 15 concepts were identified,
including 9 newly identified links.
The concept ?external factors? was linked with all 6 concepts relating to (inter)organizational
mechanisms; ?task characteristics?, ?structure?, ?knowledge and information technology?,
?administrative operational processes?, ?cultural factors? and ?need for coordination?. Five
of these concepts related to 3 concepts of relational coordination; ?roles?, ?quality of
relationship? and ?exchange of information?. The concept of ?task characteristics? was only
linked with ?roles? and ?exchange of information?. The concept ?patient characteristics?
related with the concepts ?need for coordination? and ?patient outcome?. Outcome was
influenced by ?roles?, ?quality of relationship? and ?exchange of information?.
Conclusions
External factors and the (inter)organizational mechanism should enhance ?roles? and ?quality
of relationship? between healthcare professionals and with the patient as well as ?exchange of
information?, and setting and sharing of common ?goals? to improve care coordination and
quality of care.status: publishe