Do existing mechanisms contribute to improvements in care coordination across levels of care in health services networks? Opinions of the health personnel in Colombia and Brazil

Table 1 Types of mechanisms targeted to improve care coordination

Coordination basis	Theoretical coordination mechanisms		Care coordination mechanisms
Programming	Standardization of skills		Expert system: continuing medical training, alternatives to traditional consultations (case review, clinical sessions, etc.)
	Standardization of work processes		Clinical guidelines, healthcare maps, pharmacological guides, discharge planning;
			Patients’ referral protocols and pathways;
			Shared appointment system;
			Action planning system.
	Standardization of outputs		Healthcare maps;
	Standardization of outputs		Performance monitoring systems.
Feedback	Direct supervision		Program or process manager.
	Mutual adjustment	Informal communication	E-mail, post, web, phone, informal meetings.
		Liaison mechanisms	Multidisciplinary, interdisciplinary and transdisciplinary healthcare teams;
			Liaising job posts: case manager and patient referral centres;
			Permanent committees: cross-level management committee;
			Integration manager: care manager, cross-field manager;
			Matrix design.
		Integrated information system	Referral and counter-referral form;
		Integrated information system	Clinical information systems.

Source: Adapted from Terraza et al. [12] based on Mintzberg [15] and Galbraith [16]

ISSN: 1472-6963