Case management for high-intensity service users: towards a relational approach to care co-ordination

摘要: This study is based on a formative evaluation of case management service for high-intensity users in Northern England. The had three main purposes: (i) to assess the quality organisational infrastructure; (ii) obtain better understanding key influences that played role shaping development service; and (iii) identify potential changes practice may help improve provision. was informed by Gittell's relational co-ordination theory, which focuses upon cross-boundary working practices facilitate task integration. Assessment Chronic Illness Care Survey used infrastructure qualitative interviews with front line staff were conducted explore shaped service. A high level strategic commitment political support integrated identified. However, care variable. most prominent operational factor appeared influence scope pattern interaction between managers their co-workers. patient much more effective networks. Key features included clearly defined, focussed, workspaces interactive forums where could engage co-workers discussions about interdependent activities. In dispersed networks fewer workspaces, struggled work as effectively. concluded creation flexible efficient focused are systemically managed adequately resourced co-ordination, particularly