Effects of provider characteristics on care coordination under comanagement

Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine
Keiki HinamiDavid O Meltzer

Abstract

Care coordination is critical in settings characterized by high levels of uncertainty, time constraints, and interdependent work processes. The effects of provider characteristics on coordination in comanaged teams has never been examined. To characterize individual providers based on their contribution to team coordination. Hospitalists, nonphysician providers, hepatologists, and fellows on a comanaged liver service of an academic hospital. Between April 2008 and October 2008, participants were surveyed at baseline and repeatedly at the completion of physician rotations to assess their preferred and actual comanagement structures. In addition, they repeatedly rated their comanagers' contributions to overall coordination using an instrument that assessed relational coordination (RC). Providers were categorized into tertiles of RC. Their management preferences and the frequency of a "composite bad outcome" (intensive care unit [ICU] transfer or inpatient death) in each tertile were evaluated. All (100%) Baseline Surveys and 177/224 (79%) Repeated Surveys were completed by 32 providers. RC was shown to be a stable attribute of providers and not of adverse patient outcomes. Higher coordinators were characterized by their "ownershi...Continue Reading

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Citations

Jan 1, 2014·Health Care Management Review·Nathalie McIntoshMartin Charns
Sep 15, 2011·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Keiki HinamiDavid O Meltzer
Oct 7, 2014·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·David I RappaportLisa M McLeod
Sep 1, 2015·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Caroline K TietbohlDominick L Frosch
Feb 11, 2014·Journal of Nursing Care Quality·Nathalie McIntoshMartin Charns

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