Shared Understanding in Care Coordination for Children's Behavioral Health

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Care coordination involves crossing boundaries to connect services in support of the health and well-being of an individual. In this paper, we describe how care coordination depends on the ability to develop shared understanding of care goals and progress. A distributed group of professionals and non-professional caregivers need to share information to provide consistent and holistic support across settings. We conducted fieldwork comprising of 20 interviews and 51 hours of observation across three different programs focused on children’s behavioral health. From this empirical investigation of practices used by distributed care teams, we generated a conceptual framework of shared understanding in care coordination. We identified barriers to shared understanding, as well as nine practices that contribute to its development via two key mechanisms: (1) building relationships across boundaries, and (2) sharing actionable information. We conclude with design implications for enhancing the collaborative practices of members of a care team to cross boundaries despite the barriers that are common in behavioral health and other contexts requiring complex care coordination.