PRP044: Care coordination between primary and oncology care: A qualitative study of a nurse coordinator role and external coaching

Eric Shaw, PhD; Bijal Balasubramanian, PhD, MBBS; Robin Higashi, PhD; Serena Rodriguez, PhD, MA, MPH; Simon Lee, PhD, MPH; Patricia Chen, PhD, MPA; Jessica Austin, PhD, MPH


CONTEXT: Cancer survivors with multiple chronic conditions commonly traverse multiple care delivery settings: primary, oncology, and other specialty care teams. Because U.S. healthcare delivery is highly fragmented, new efforts are needed to coordinate effective care. Project CONNECT, a quasi-experimental pragmatic trial, embedded a novel nurse coordinator to bridge primary care and oncology teams within a safety-net healthcare system. An external coach provided ongoing support and development for this new role. OBJECTIVE: To describe efforts to integrate the nurse coordinator across care teams and assess the role of external coaching on advancing role comprehension and activities. STUDY DESIGN, SETTING, and POPULATION: This qualitative study was conducted within a larger NCI R01 parent study (Project CONNECT) at a U.S. urban, integrated safety-net health system. Data included notes from external coaching sessions with two consecutive nurse coordinators between 2017-2020 combined with observation and interview notes of the integration process. Data were analyzed by a team of researchers trained in qualitative methods using an immersion-crystallization approach to identify and characterize key themes and to synthesize findings. RESULTS: External coaching sessions utilized multiple coaching strategies tailored to multilevel factors such as health system events, nurse coordinator traits, and the coordinators’ prior experience. The coaching process facilitated integration of the new role as the nurse coordinator navigated multiple complex internal systems and sought to build and maintain relationships across teams. Initial analyses identified multiple coaching strategies and tactics used including: providing a connection to the research team that was instrumental in ensuring a clear understanding of the nurse coordinator role; providing support and encouragement to address challenges; and (re)framing a problem or question to identify new approaches or solutions. We anticipate that our in-depth, cross-code analyses will yield additional insights. EXPECTED OUTCOMES: With a paucity of research to guide integration of new roles, e.g. coordination to bridge patient transitions between care teams, the current study will contribute to the existing knowledge base on intervention implementation, identify factors to support intervention maintenance, and advance efforts to improve care coordination outcomes for complex patients.

Social Media


11400 Tomahawk Creek Parkway
Leawood, KS 66211