Development of a Framework for the Competency “Coordinating Care and Services for People With Complex Needs”: A Participatory Methodological Study

Abstract

Introduction: Coordinating care and services for people with complex needs is an essential competency for nurses. However, this competency has not been fully integrated into entry-level and continuing nursing education and is not explicitly included in Quebec’s nursing competency frameworks. This study aims to develop a framework for this competency in order to support its integration into nursing education and to promote greater consistency in clinical practice.

Method: Based on a participatory organizational methodological approach, the study was conducted in two phases and engaged stakeholders from clinical, academic, and institutional settings. Led by the research team in collaboration with a committee of experts, the first phase identified the core dimensions of care coordination and their indicators through an analysis of professional practice. In the second phase, the Delphi method was used to consult nurse care coordinators and their immediate managers to validate the relevance, clarity, and comprehensiveness of the proposed framework.

Results: The framework developed in this study comprises four dimensions and 16 indicators. During the first Delphi round, 100% of the dimensions and indicators were rated as relevant and clear (consensus level ≥ 82.4%), with the exception of one indicator, which was reworded to improve clarity. Participants also proposed the addition of a preamble incorporating cross-cutting ethical and professional principles; this addition was deemed relevant by 100% of participants during the second Delphi round.

Discussion and Conclusion: This framework clarifies the responsibilities and roles associated with care coordination, a function that is often ambiguous within interprofessional practice. It builds on previous work highlighting the variability of care coordination models and the need for a structured framework. From an educational perspective, the framework provides a foundation for designing learning activities aligned with the needs of clinical practice settings. Future studies are needed to test its application in real-world contexts and to evaluate its impact on the quality of care and on patients’ experiences.