Maintaining excellence in care coordination during the COVID-19 pandemic and beyond: a survey of multidisciplinary healthcare teams in Ontario, Canada

Introduction: Patients with comorbidities have been shown to experience increased vulnerability during the COVID-19 pandemic, and to suffer disruption in their care coordination; having a multidisciplinary team is a care coordination strategy that can improve outcomes. The aim of this study was to describe the perspectives of team leads on coordination practices at their multidisciplinary health team (MHT) prior to, and during the COVID-19 pandemic. Methods: Using a cross-sectional survey design, the Medical Home Care Coordination Survey for healthcare teams was distributed by email to executive directors or physician leads at all MHTs in Ontario, Canada. The outcome measures included the eight domains of care coordination, and participants' rating of care coordination in general. Results: The response rate was 58/241 (24%); 70% (95% CI: 0.50, 0.76) of teams reported using a validated method to identify complex patients in need of care coordination. High ratings for most items in the domains of care coordination prior to COVID-19 were maintained during the pandemic. Improvements can be made in providing patients with a copy of their care plan, making peer support accessible, and ensuring the timely inclusion of discharge summaries in the primary care record. Most participants (72%) rated care coordination in general at their MHT as very good or excellent prior to the pandemic; this decreased to 59% during the pandemic (p=0.016; 95% CI: -0.048, 0.31). Discussion: To improve care coordination beyond the pandemic, providers should consider increasing the use of validated tools to identify patients with complex needs, and incorporating peer support systems to enhance care coordination efforts.