Improving Outcomes Through Care Coordination by Ruggiero et al. Research Paper

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Care coordination is often seen as a key to addressing healthcare system issues. The current policy statement by the American Academy of Pediatrics and defines CC as “a patient and family-centered, assessment-driven, team-based activity created to meet the needs of children while enhancing the caregiving capabilities of families. It interrelated medical, social, developmental, behavioral, educational and financial needs to achieve optimal health and wellness outcomes” (Ruggiero et al., 2019). Care coordination is a critical element within the pediatric healthcare system, and it has been defined as a collection of actions that take place in the area between providers, visitors, and entities and is becoming increasingly important to evaluate the effect it has on health outcomes.

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The study conducted by Ruggiero, K., Pratt, P., & Antonelli, R. seeks to examine the role of Nurse Practitioners in the care coordination system. Its primary purpose is to assess the role and possible influence of Nurse Practitioners through the quantitative study conducted in two clinics. The study problem is viewed with an eye on the current development of the health care system when it, with its integral complexity, attempts to move into the community settings, such as infusion settings. At the forefront of the growing demands for quality care coordination stand Nurse Practitioners, who support several infusion programs.

The study design can be described as quantitative since the study’s goal is to find out how individuals believe, behave, or feel in a particular manner. Quantitative research uses vast sample sizes and focuses on the number of replies rather than the more focused or emotional understanding that qualitative research seeks. The clinic sample used in the research was the two clinics, which are part of the children’s hospital (Ruggiero et al., 2019). The study sample was limited to the children who were receiving infusion therapies. The sample set can be identified as medium-sized since the data amount was collected only from two clinics.

The instrument used in the study was the modified version of the care coordination measurement tool. During the research, the care coordination activities were investigated, the interactions by Nurse Practitioners were measured, and the results were thoroughly documented and analyzed (Ruggiero et al., 2019). With regard to the modification of the original care coordination measurement tool, initially adapted for pediatric care coordination, the authors managed to include other settings, such as pediatric neurology, perioperative ambulatory clinics, etc. (Ruggiero et al., 2019). Within these settings, several improvements were made, mainly concentrating on the incursion of the specific settings relevant to the Nurse Practitioners. As mentioned in the study, after 80% agreement on the modifications by the panel of experts, it served as the primary instrument for data gathering and analysis for this research (Ruggiero et al., 2019). Thus, the initial care coordination measurement tool was adopted by the authors to conduct the analysis based on specifically Nurse Practitioner’s impact.

It should be mentioned that the instrument used for the study is relevant and reliable. After a two-staged assessment of the author’s modifications to the care coordination measurement tool, it was approved by an expert panel of Nurse Practitioners, patients, and expert clinicians (Ruggiero et al., 2019). Therefore, to achieve the stated research objectives, this tool was best suited. Moreover, these modifications can be used in further studies on the topic, which increases the significance and justification for its usage.

The statistical analysis used for the study’s data shows that more than 250 interactions related to care coordination were investigated and analyzed. In most cases, Nurse Practitioners were providing primary care concerns, such as family needs, concerns (more than 70 percent), and the advocation for the patient/family (more than 50 percent) (Ruggiero et al., 2019). The other set of data was focused on the outcomes that were prevented by the efforts of Nurse Practitioners. In most cases (almost 100 entries, nearly 40 percent), it was the delay in treatment (Ruggiero et al., 2019). The last set of statistical data aims at the evaluation of the time needed to complete care coordination procedures. The data analyzed in the research shows that the most common encounters with Nurse Practitioners lasted from 10 to 19 minutes (Ruggiero et al., 2019). These sets of statistical data are implied to analyze the involvement of Nurse Practitioners in the care coordination system and evaluate their performance.

The reliability and validity of the study should be assessed carefully due to the study’s limitations. Since it is based on self-reports, reliability cannot be described as objective in any case (Ruggiero et al., 2019). Every respondent has his own subjective understanding of care coordination; therefore, the study can not be hundred percent valid and reliable. In further research, this should be considered and noted.

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A similar issue arises when trying to assess the generalizability of the study. As it was mentioned in the article, the project was limited in scope to two clinics within one hospital, which implies the inability to generalize the outcomes and apply them to the other settings (Ruggiero et al., 2019). However, the study aims at further research which intends to be more global and with more degree of possible generalization.

Aside from demographics, the research assesses the role of Nurse Practitioners in the field of care coordination and concludes that the understanding of it is critical in terms of the future of the health management of CMC. Nurse Practitioners seem to be in the midst of the shifting priorities of the healthcare system; moreover, they can influence and improve the care coordination system. The primary study outcome is that Nurse Practitioners are in the perfect position for the adaptation and development of care coordination.

The study investigated how the role of Nurse Practitioners enhances care coordination and their importance in general. This article was the first to analyze the activities performed by nurse practitioners in the ambulatory practice setting (Ruggiero et al., 2019). Within this, the authors suggested that the next of the research would be to evaluate the cost savings of the nurse practitioners in relation to care coordination. Based on the foundation of this study, this aim is seen to become the next step in the development of this project.

Proceeding from the aforementioned, this project can be considered an important one in terms of the future of Nurse Practitioners’ practice developments. The role of care coordination is crucial for the healthcare system, and Nurse Practitioners are one of the main parts of enhancing care coordination capabilities. Based on the future assumptions of the authors, this study can be identified as of extreme relevance and importance in the field.

Reference

Ruggiero, K., Pratt, P., & Antonelli, R. (2019). Improving outcomes through care coordination: Measuring care coordination of nurse practitioners. Journal of the American Association of Nurse Practitioners, 31(8), 476-481.

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