Turning on the care coordination switch in rural primary care: voices from the practices--clinician champions, clinician partners, administrators, and nurse care managers

J Ambul Care Manage. 2011 Jul-Sep;34(3):304-18. doi: 10.1097/JAC.0b013e31821c63ee.


This study sought to understand the acceptability and feasibility of office-based nurse care management in medium to large rural primary care practices. A qualitative assessment of Care Management Plus (a focused medical home model for complex patients) implementation was conducted using semistructured interviews with 4 staff cohorts. Cohorts included clinician champions, clinician partners, practice administrators, and nurse care managers. Seven key implementation attributes were: a proven care coordination program; adequate staffing; practice buy-in; adequate time; measurement; practice facilitation; and functional information technology. Although staff was positive about the care coordination concept, model acceptability was varied and additional study is required to determine sustainability.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Ambulatory Care Facilities
  • Female
  • Health Facility Administrators
  • Humans
  • Male
  • Medical Informatics Applications
  • Middle Aged
  • Nurse Administrators
  • Nursing Care / organization & administration
  • Oregon
  • Organizational Innovation*
  • Patient Care Management / organization & administration*
  • Patient Care Team
  • Primary Health Care / organization & administration*
  • Qualitative Research
  • Rural Health Services / organization & administration*
  • Young Adult