Table 5 Interview responses about system-level coordination activities
Care coordination activity | Interview/respondent site | ||
|---|---|---|---|
Response 11 | Link to community resources | Interview 1/SNF | “It doesn’t give any information about the services that they provide or the quality. And unfortunately that’s how these things stand, and most of these suggestions are being made based on the patient’s distance from the family and not much thought is being put into it. That’s the standard practice. There are some hospitals which are now trying to use nursing home compare websites, which has the benefit that it has the star ratings and some quality markers on it.” |
Response 12 | Align resources with patient and population needs | Interview 6/ACH | “We build queues or use questionnaire functionalities within the EHR and then we can routinely get data back on it. So for example, what interventions did the nurse do in terms of care coordination? So we know that the primary intervention the nurse making the call has to do is medication and navigation. So did the patient get their appointment, their meds? There are about ten potential interventions but those are the top two, just to give you some examples.” |