A Multi-Domain Taxonomy of Advanced Nurse Led Care Coordination for Complex and Chronic Care
DOI:
https://doi.org/10.61978/curatio.v2i4.1412Keywords:
Care Coordination, Advanced Practice Nursing, Chronic Disease, Multimorbidity, Transitional Care, Integrated CareAbstract
Health systems increasingly face fragmentation as chronic disease and multimorbidity require care spanning multiple providers, settings, and sectors. Advanced practice nurses are often positioned as care coordinators, yet nurse-led coordination remains variably defined and operationalized. This study aimed to develop a comprehensive, practice-oriented taxonomy of advanced nurse-led care coordination strategies for complex and chronic care. A conceptual framework development design integrated concept clarification, theory-informed synthesis, and classification-oriented evidence mapping, drawing on literature on care coordination, transitional care, chronic disease management, and nurse navigator/coordinator roles to identify recurring coordination activities. The analysis produced a multi-domain taxonomy spanning assessment, planning, transition, monitoring, and evaluation. Core activities attributable to advanced nurse roles included patient identification and multidimensional assessment, information brokerage, navigation and cross-sector linkage, longitudinal monitoring, and patient/caregiver coaching. The taxonomy integrates transitional care mechanisms with longitudinal chronic care processes, addressing under-specified areas such as role accountability, communication systems, and evaluative feedback loops. Nurse-led coordination was most consistently linked to improved patient experience, perceived support, and continuity, while utilization effects varied by context. The proposed taxonomy advances conceptual clarity and operational specificity, offering a scaffold for program design, workforce development, policy decision-making, and further empirical testing.
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