Abstract
Background: Millions of people globally live with complex health and social care needs that go beyond the services typically provided by a healthcare system. Consequently, developed countries, including Canada, have invested in health and social care coordination to address these needs and improve individuals' experiences within these systems. Despite nurses being increasingly relied upon for care coordination, their knowledge of coordination principles remains limited, as these principles are not fully integrated into nursing curricula or continuing education. Nurses rely on experiential knowledge, often improvised or transmitted by mentors, yet gaps in coordination persist in their daily practice. Recent studies indicate suboptimal deployment of coordination and communication activities in nursing practice. There is a need to develop the competency of « coordinating care and services for patients with complex needs » through initial or continuing education. The first step towards this aim is to identify the dimensions and indicators of this competency.
Objective: to develop a comprehensive reference framework for the competency of « care and services coordination for patients with complex needs », addressing the current gaps in nursing education and practice.
Study Design: Based on the principles of Organizational Participatory Research (OPR), an innovative approach aligning organizational stakeholders and academics, this study employs a sequential exploratory mixed-methods design. The first qualitative phase involves engaging in-depth focus group discussions with five experts to meticulously identify relevant dimensions and indicators. These experts, possessing substantial clinical or research experience in care coordination, are complemented by the inclusion of experiential knowledge from a patient partner. The subsequent quantitative phase incorporates a Delphi survey involving 30 nurses occupying coordination positions, contributing to the validation of the identified dimensions and indicators. A non-decisional advisory committee, comprising representatives from the national nursing care direction, the Order of Nurses of Quebec, and the Nursing Care Direction of involved clinical settings, actively guides the study, ensuring its relevance and applicability.
Results: Four dimensions of the competency framework have been successfully validated by the expert committee. These dimensions underscore the importance of intervention with patients and their relatives throughout the care journey, seamless collaboration with intra and interdisciplinary teams, the establishment of continuity of care, the embodiment of collaborative leadership, and the mastery of effective communication skills. Indicators, meticulously formulated and rigorously validated, enable the measurement of achievement in each identified dimension. Additionally, a contextualization effort for the reference framework was undertaken, ensuring its adaptability and alignment with the nuanced realities of nursing practice in Quebec.
Learnings: This presentation serves as an invaluable guide for international academic researchers and healthcare professionals, showcasing the adaptive potential of the OPR approach in refining and contextualizing a reference framework.
Next Steps: The imminent finalization of the Delphi survey analysis and the implementation of knowledge transfer activities are pivotal steps in optimizing the provincial-level adoption of this newly developed competency framework, heralding a transformative era in nursing education and practice.