Abstract
Background: Enhancing care coordination is recognized as a crucial pillar for integrated, continuous, and patient-centered primary care. This requires specialized knowledge and specific skills. However, current training programs in care coordination rarely rely on a competency framework specific to coordination. Instead, they often depend on books, scientific articles, and a few theoretical models. The few existing competency frameworks are primarily designed for American and Swiss contexts, without considering the socio-political and legal particularities of Quebec. To address these gaps, it is essential to contextualize this competency to reflect the specific realities of Quebec's nursing care. Therefore, we have developed a care coordination competency framework following an organizational participatory research (OPR) approach.
Approach: A mixed-methods design was employed in this OPR approach that allowed increased collaboration in research between academic, professional, and clinical settings :
In the qualitative phase, we conducted five focus groups with experts to translate a theoretical model, « A model of nursing care coordination activities for patients with complex needs », into a care coordination competency framework specific to the Quebec context.
The quantitative phase is ongoing and aims to validate this framework with 30 nurses occupying coordination positions.
In addition to experts and care coordinators, this project involves an 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 guiding the study to ensure its relevance and applicability. A patient partner is also involved in all stages of this project.
Results: The competency framework has been successfully validated by the expert committee. It includes four dimensions and 16 indicators that emphasize 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.
Implications: A common understanding of what care coordination means across Quebec's health and social services would facilitate the development and planning of training activities at the local and regional levels and allow for equitable, comprehensive, quality, and comparable services from one region and service to another.
The 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.