Enhancing Care Coordination for Students with Type 1 Diabetes.

Abstract

Care coordination for chronic health conditions is critical to academic success, yet concrete strategies on its operationalization in schools are not well reported in the literature. Type 1 diabetes (T1D) is one such condition that requires a team-based approach to care coordination. The purpose of this study was to gain a deeper understanding of how care coordination for T1D currently operates and identify strategies for its support and facilitation in schools. Focus groups were conducted with school nurses, parents of T1D children, and providers in each of the 9 Educational Service Districts in Washington State. Recorded notes were analyzed using content analytic techniques. Five major themes emerged from the data, each with 3 to 4second-order themes. Care coordination depended on family, school, and child developmental contexts, knowledge/experience about T1D among school nurses, teachers, parents, and providers, access and availability of team members, communication, and relationships. Findings highlight the importance of a contextualized and holistic perspective of facilitators and barriers to care coordination in schools. Promoting the development of supportive relationships and effective team-based approaches provides a foundation and informs intersectional care coordination for all children with chronic conditions.