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Currently submitted to: JMIR Research Protocols

Date Submitted: Jun 12, 2019
Open Peer Review Period: Jun 12, 2019 - Jun 20, 2019
(currently open for review and needs more reviewers - can you help?)

Development and Implementation of a Nurse-Led Model of Care Coordination to Provide Health-Sector Continuity of Care for People with Multimorbidity: Protocol for a Mixed Methods Study

  • Kate M Davis; 
  • Marion C Eckert; 
  • Sepehr Shakib; 
  • Joanne Harmon; 
  • Amanda D Hutchinson; 
  • Greg Sharplin

ABSTRACT

Background:

Innovative strategies are required to reduce care fragmentation for people with multimorbidity. In response, coordinated models of health care delivery need to be adopted to deliver consumer-centred continuity of care. Nurse-led services have emerged over the past 20 years as evidence-based structured models of care delivery, providing a range of positive and coordinated healthcare outcomes. Although Nurse-led services are effective in a range of clinical settings, strategies to improve continuity of care across the secondary and primary health care sectors for people with multimorbidity have not been examined.

Objective:

To implement a nurse-led model of care coordination from a multi-disciplinary outpatient setting and provide continuity of care between the secondary and primary health care sectors for people with multimorbidity.

Methods:

This action research mixed methods study will have two phases. Phase one includes a systematic review, stakeholder forums and validation workshop to collaboratively develop a model of care for a nurse-led care coordination service. The second phase, through a series of iterative action research cycles, will implement a nurse-led model of care coordination in a multidisciplinary outpatient setting. Three to five iterative action research cycles will allow the model to be refined and further developed with multiple data collection points throughout.

Results:

Pilot implementation of the model of care coordination commenced in October 2018. Formal study recruitment commenced in May 2019 and the intervention and follow-up phases are ongoing. The results of the data analysis are expected to be available by March 2020

Conclusions:

Nursing, clinician and patient outcomes and experiences with the nurse-led model of care coordination will provide a template to improve continuity of care between the secondary and primary healthcare systems. The model template may provide a future pathway for implementation of nurse-led services both nationally and internationally.


 Citation

Please cite as:

Davis KM

Development and Implementation of a Nurse-Led Model of Care Coordination to Provide Health-Sector Continuity of Care for People with Multimorbidity: Protocol for a Mixed Methods Study

JMIR Preprints. 12/06/2019:15006

DOI: 10.2196/preprints.15006

URL: https://preprints.jmir.org/preprint/15006


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