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Letter to the Editor

  • Thank you for giving us the opportunity to respond to the letter to the editor written by Lisa Palucci. We are pleased to see her interest in older adults with multimorbidity and advancing models of care and care coordination for this growing population group.

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Letter to the Editor by Lisa Palucci to “Registered Nurse Care Coordination: Creating a Preferred Future for Older Adults with Multimorbidity”

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February 19, 2019

Response by Lisa Palucci to “Registered Nurse Care Coordination: Creating a Preferred Future for Older Adults with Multimorbidity” by Jean Scholz and Judith Minaudo (September 30, 2015)

With Reply from Authors

Dear Editor,

I am writing in response to the September 2015 article titled “Registered Nurse Care Coordination: Creating a Preferred Future for Older Adults with Multimorbidity” (Scholtz & Minaudo, 2015). I came across this article in my older adult care literature searches and although my area of focus is not care coordination, it is something that is near and dear to my heart. I absolutely agree with the major content of this article, especially the emphasis it places on registered nurses taking the lead in care coordination models of care. However, I truly believe that until health disparities and inequities are included in the care coordination efforts will we then begin to close the gap of the Institute for Healthcare Improvement’s Triple Aim Initiative (Institute of Healthcare Improvement, 2018) and the legislative intent of the Affordable Care Act of 2010 (Patient Protection, 2010).

As a DNP student researcher interested in optimal care for older adults, I have yet to come across a care coordination article that is more inclusive of minority populations and those individuals that live in rural locations. Scholtz and Minaudo (2015) identify communication skills as a required attribute, yet they also mention that unlicensed personnel, such as medical assistants, have been used as interpreters and coaches for someone within a specific ethnic group. I feel that patients from different ethnic backgrounds deserve equitable care, received from a registered nurse versus unlicensed personnel. All of the models of care examples discussed are part of large healthcare systems, with little mention of smaller healthcare systems of care, especially those that are located in rural areas (e.g., the Indian Health Service, a federal healthcare entity). I recognize that there are limitations to the inclusion of health equity and rural healthcare systems in discussions surrounding care coordination. I encourage you to consider these limitations and provide a follow-up article that includes how care coordination can be consistent across multicultural settings.

Sincerely,

Lisa Palucci, MSN, RN
Broomfield, CO
Email: palucci.lisa@gmail.com

References

Institute for Healthcare Improvement (2018). Initiatives. Retrieved from: http://www.ihi.org/Engage/Initiatives/TripleAim/Pages/default.aspx

Patient Protection Affordable Care Act. (Public Law 111-148). (2010, March 23). 111th United States Congress. Washington, D.C.: United States Government Printing Office. Retrieved from http://www.gpo.gov/fdsys/pkg/PLAW-111publ148/pdf/PLAW-111publ148.pdf.

Scholtz, J., Minaudo, J. (2015). Registered nurse care coordination: Creating a preferred future for older adults with multimorbidity. OJIN: The Online Journal of Issues in Nursing, 20(3). Manuscript 4. DOI: 10.3912/OJIN.Vol20No03Man04

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