CQI: Framework for Implementing Care Coordination

There is a marked rise of poor sentiment toward issues relating to our most vulnerable and at-need populations. On the one hand we are appalled by budget cuts and political gamesmanship which would reduce or eliminate funding for programs designed to help the populations who truly need it.

On the other hand we are seeing more restrictions and scrutiny of those who are trying to care for a loved one or a client/family in need. The rhetoric has become downright nasty, accusatory and misleading.

Now, more than ever, the human services system is in need of non-traditional approaches in order to effectively coordinate services among disparate providers and to deliver services to persons in need who live in our communities. By adopting a Continuous Quality Improvement model (Plan, Do, Review) particularly focusing on the “Review” aspect thereof, systems will operate more efficiently in terms of personal service as well as fiscal responsibility for our most vulnerable populations.

The treatment of persons in need residing in our community and their cross-utilization of disparate agencies and services is so fragmented that only a comprehensive entity, understanding the abilities and limitations of the various agencies affecting them, allows for their productive treatment. Moreover, CQI as applied via Care Coordination addresses the perceptions and contemplates the needs of stakeholders in a most comprehensive manner.

CQI must be borne of, and accepted by top administration. In order to be truly effective, all stakeholders and constituents must feel that their needs are addressed under any system of change, that proposals are not simply “Change for change sake” and that, collectively and individually, there is benefit to restructuring processes.

It is essential to the success of any delivery system which purports to integrate service providers and disparate agencies to include a monitoring and reporting (CARE COORDINATION) component to ensure the ongoing, good-faith and cooperation of the individuals and service providers. Such a monitoring agency will be the constant source of information throughout the consumer’s lives no matter where their particular needs may fall along the ever changing continuum in any service system.

Finally, this independent third party agency is a vital component of an effective and comprehensive “Plan, Do, Review” model of Continuous Quality Improvement in the human services fields. The formula of CQI and its implementation under Care Coordination have demonstrated their efficacy in disparate human/social service systems of care.

This goes far beyond Care Management and encompasses the continuum outside of the home and healthcare settings to include every facet of a meaningful and fulfilled life in the community for the patient, her loved ones and her care providers.

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