Relational Coordination in Veterans Affairs Home-Based Primary Care

Hulen E, Laliberte A, Saha S, Edwards ST. Relational Coordination in Veterans Affairs Home-Based Primary Care. Journal of interprofessional education & practice. 2023 Sep 1; 32:https://doi.org/10.1016/j.xjep.2023.100665.

Related HSR&D Project(s)

• CDA 16-152 – Optimizing Outcomes in Home-Based Primary Care
• PPO 20-325 – Applying Novel Analytic Methods to Address the Impact of Race on Patient-Provider Communication

Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects.

If you have VA-Intranet access, click here for more information vaww.hsrd.research.va.gov/dimensions/

VA staff not currently on the VA network can access Dimensions by registering for an account using their VA email address.    Search Dimensions for VA for this citation
* Don't have VA-internal network access or a VA email address? Try searching the free-to-the-public version of Dimensions

Search for Abstract from PubMed

---

Abstract:

Department of Veterans Affairs (VA) home-based primary care (HBPC) is an intensive primary care program in which interdisciplinary teams care for patients with complex, chronic medical and social needs in their homes. HBPC teams consist of multiple disciplines, perform complex, interdependent tasks, coordinate care with other providers to meet patient needs. Relational coordination (RC) is a mutually reinforcing process of communicating and relating that provides the information-processing capacity to coordinate complex, interdependent tasks. In this mixed-methods study, we examined RC within home-based primary care teams (HBPC), and between clinic-based primary care providers and HBPC team members. RC was assessed by a cross-sectional survey of 33 HBPC team members and semi-structured interviews with 14 HBPC and 10 clinic-based PCPs were conducted to explicate findings. Survey results showed strong RC within HBPC teams but gaps in timely communication and shared knowledge among HBPC teams and clinic-based PCPs. These gaps may underlie confusion and frustration over the role of HBPC and what types of patients should get HBPC care. Interview data suggest that functional specialization and lack of face-to-face interactions may have hindered the development of strong RC. Interventions that promote boundary spanning may improve RC between HBPC teams and clinic based primary care.