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Improving care coordination in community physical rehabilitation: A qualitative study of the change framework

Symons, JL, Jamison, J, Dening, J, Murray, L and Pearson, S ORCID: 0000-0001-6592-6494 2019 , 'Improving care coordination in community physical rehabilitation: A qualitative study of the change framework' , International Journal of Care Coordination, vol. 22, no. 3-4 , pp. 140-147 , doi:

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Introduction: Contemporary rehabilitation change relies on effective collaboration and ongoing social interactionsamong stakeholders. The study objective was to explore the influence of the selected change framework and underlyingsocial interactions during a care coordination improvement project.Methods: A qualitative study collected data from 35 employees in a community physical rehabilitation service.Participants were not only undergoing change to improve client care coordination but were also facilitating thechange processes themselves. Symbolic interactionism guided the research design, and data were collected using interviews and observation. Blumer’s six root beliefs were used for deductive data analysis and provided the framework forthe findings.Results: Findings highlight that the perceptions of the selected change framework were mixed yet dynamic, withmodification occurring via social interaction. Elements of Kotter’s eight steps, lean thinking, and transformationalchange models were trialed. Implementation of the change processes required formal and informal group social interactions. Participants’ different outlooks explained their mixed response to the change processes. Participants whosupported the implemented changes believed the processes and outcomes were clear, appropriate, and inclusive.Time, energy, and positive social interactions enabled employees to drive change, with more of these resources desiredto refine the vision, problem-solve implementation, and further improve care coordination.Discussion: This study enhances the understanding of how employees and the community physical rehabilitationservice shaped each other during the change processes. The focus on social interactions highlights the slow rate ofimproved care coordination and need for increased resources and/or duration for successful change.

Item Type: Article
Authors/Creators:Symons, JL and Jamison, J and Dening, J and Murray, L and Pearson, S
Keywords: community health services, rehabilitation, coordination, health services for people with disabilities, quality improvement, change management
Journal or Publication Title: International Journal of Care Coordination
Publisher: Sage Publications Ltd.
ISSN: 2053-4345
DOI / ID Number:
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Copyright The Author(s) 2019

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