Fragmented systems and communication breakdowns contribute to devastating consequences for patients

Care coordination aims to remedy this. At MacColl, we view care coordination as a system function, rather than an individual role or job description.

MacColl’s work helps clinical teams coordinate care throughout a system

We have developed models and toolkits for minimizing care fragmentation, and with projects like PCT-LEAP are gathering data from the best and the brightest clinical teams to share innovations in care coordination.

Related Resources

Ed Wagner on Caring for Complex Patients: BRIDGES Conference 2014 Keynote

BRIDGES Conference 2014: Ed Wagner Keynote Talk

Building Bridges to Integrate Care (BRIDGES) is a Toronto-based incubator for innovative models to integrate care across the continuum and across disciplines for people with complex chronic disease. Watch this video to learn more about Ed Wagner's thoughts about the challenges of caring for complex patients, including current lack of evidence for creating clinical guidelines, the complications of multiple medications, providers and services, and the lack of coordination between physicians, services and agencies.

The Team Guide

We know transformation of any kind is hard work. That’s why we’ve created the Team Guide, an online tool for primary care teams. The Team Guide helps build high-functioning teams and provides practical, hands-on tools—easy to use, actionable and measureable. Useful for practices at any stage, the Team Guide is built in modules, enabling practices to easily pinpoint relevant topics and areas of interest. It’s free, with a wide array of downloadable tools and resources.

Accelerating Regulatory Progress in Multi-Institutional Research

MacColl Center Business Manager Sherry Lauf and Senior Program Manager Leah Tuzzio co-authored this manuscript highlighting three case studies in which research, regulatory, and administrative teams developed and employed innovative approaches to secure and maintain Institutional Review Board approvals, enable data sharing, and expedite sub-award issuance and execution.

Aligning Forces for Quality

Our team provides assistance to the 16 communities participating in Aligning Forces for Quality, advising the National Program Office on regional quality improvement (QI) strategies, community drivers for improved healthcare, and how to sustain QI structures and supports once the grant period has ended. MacColl’s  Dr. Ed Wagner has also served on its National Advisory Committee since 2007.

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