Recognizing, Measuring, and Improving Staff Nurse Care Coordination in the Hospital

Purpose:
The purpose of this presentation is to describe the scope of nurse care coordination activities in the hospital and to share new strategies and a new research-based education program to assist nurses to recognize, measure, and improve their care coordination.

Significance:
Much of the work staff nurses do to coordinate care is invisible to patients, families, and team members. Comprehensive description of nurse care coordination activities and systematic attention to recognizing and improving nurse care coordination is critical to quality and safety outcomes.

Strategy and Implementation:
Nurse care coordination activities we will discuss were identified during a two-year Robert Wood Johnson (RWJF) INQRI project. Staff nurses in 4 hospitals were observed for 160 hours and 40 interviews were conducted with nurses and team members. A new nurse care coordination measure was developed and tested on 33 nursing units in 4 hospitals and found to be significantly related to several NDNQI measures. During the past year, funded by an RWJF dissemination grant, we worked with a team of 6 expert medical surgical nurses to translate our research findings into usable information to be readily applied within daily nursing practice. Key lessons from developing and pilot testing a new educational program on nurse care coordination and mobilizing team members will be shared. Segments of the new program will be shown and the program will be offered to conference participants to try out in their own settings.

Evaluation:
The care coordination program was piloted on two med-surg units. Care coordination strategies that nurses on the pilot units found most useful and/or challenging to improve are provided. Recommendations for nurse-sensitive care coordination process and outcome measures are highlighted.

Implications for Practice:
Recognition, measurement, and improvement of nurse care coordination practice require clear and concise definition of these practices and strategies to embed education and improvement activities in daily practice. Improvement of nurse care coordination is central to improving quality outcomes.