Who does what? How staff in England and Denmark perceive roles in the coordination of children's inpatient care: a comparison of questionnaire survey data.

AIMS AND OBJECTIVES

To explore and compare staff perceptions of their own and others roles in the coordination of care for children in hospital in Denmark and England.

BACKGROUND

The provision of well-coordinated care is a declared aim of health care providers; however, there is no universally held model for achieving this. Staff have developed ways of coordinating care in response to local conditions creating diversity and inconsistency in practice.

DESIGN

Survey.

METHODS

A structured self-administered questionnaire was used to gather perceptions of clinical staff (n = 85) about who should perform a range of specific care coordination activities. The study sites were two Danish and two English hospitals that provided local and regional children's services. Data were coded and analysis assisted by using Excel spreadsheets.

RESULTS

In both countries care coordination was perceived to involve many different staff groups. Of these, nurses and doctors were named most frequently as being responsible for coordination activities. There was consensus between countries about who should perform half the activities listed. Where there was not consensus, this was due to more frequent naming of administrative staff in the English sites and more frequent naming of nurses in the Danish sites. Overall, greater clarity about who should perform specific activities was recorded by the Danish staff.

CONCLUSIONS

Staff in England and Denmark hold many shared perceptions in relation to the performance of care coordination activities and their own roles in relation to these. However, the lack of clarity about who should perform specific tasks revealed by the English respondents indicates a greater potential here for omission or duplication of care coordination activities.

RELEVANCE TO CLINICAL PRACTICE

Clarification of who should perform specific activities may contribute to improved coordination of care by reducing the opportunity for duplication or omission in the process of care.