title: Care coordination in the spina bifida clinic setting: current practice and future directions.
abstract: BACKGROUND
  Although the potential benefits of care coordination are widely recognized, little is known about care coordination in the multidisciplinary spina bifida clinic setting. This study examined several aspects of care coordination in this environment.
  
  
  METHODS
  We conducted semi-structured interviews with clinic staff (N = 43) and focus groups with caregivers (N = 38) at seven spina bifida clinics in the United States.
  
  
  RESULTS
  Clinic staff described several primary goals of care coordination, including coordinating multiple services during one visit to ease the burden on families. Although the structure of care coordination varied across the clinics, several clinics had a dedicated care coordinator. Barriers and facilitators to care coordination included staffing issues, clinic day logistics, community resources, and family-related concerns. Despite challenges associated with care coordination processes, clinic staff and caregivers alike believed that care coordination is beneficial.
  
  
  CONCLUSIONS
  Study findings suggest ways that care might be coordinated optimally in spina bifida clinics. A synthesis of these findings for clinics interested in implementing care coordination or improving the care coordination services they currently offer is provided.
authors.affiliation: Battelle Centers for Public Health Research and Evaluation, Atlanta, GA 30329, USA. brustromj@battelle.org
authors.forename: Jennifer
authors.initials: J
authors.lastname: Brustrom
authors.forename: Judy
authors.initials: J
authors.lastname: Thibadeau
authors.forename: Lisa
authors.initials: L
authors.lastname: John
authors.forename: Jaime
authors.initials: J
authors.lastname: Liesmann
authors.forename: Shyanika
authors.initials: S
authors.lastname: Rose
mesh_terms: D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities / Q000458:organization & administration* / Q000639:trends; D017028:Caregivers / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D003142:Communication; D003376:Counseling / Q000458:organization & administration* / Q000639:trends; D005190:Family / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009718:Nurse Administrators / Q000458:organization & administration / Q000639:trends; D009723:Nurse-Patient Relations; D010348:Patient Care Team; D012017:Referral and Consultation / Q000458:organization & administration* / Q000639:trends; D016135:Spinal Dysraphism / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D014481:United States / Q000453:epidemiology; D055815:Young Adult