• The Center’s Mission

     

    Launched by the Rockville Institute in April 2011, the Center for Pathways Community Care Coordination (CPCCC) emerged as a collaborative partnership between the Rockville Institute and the Community Health Access Project (CHAP) of Mansfield, OH.  Its mission is to reduce disparities in health outcomes and health care among vulnerable at-risk populations.  This is accomplished by promoting systemic improvements in access to quality health care and social services through the adoption of evidence-based community care coordination practices.

  • The Center’s History

    The history of the Center for Pathways Community Care Coordination (CPCCC) far exceeds its youth.  As part of the Rockville Institute's partnership with the Community Health Access Project (CHAP), the Community Care Coordination Learning Network (CCCLN) transitioned from its former home at the Agency for Healthcare Research and Quality’s (AHRQ’s) Health Care Innovations Exchange to the Rockville Institute.  Initally named the National Center for Community Care Coordination, the Center is now known as the Center for Pathways Community Care Coordination to reflect its model approach to care coordination. This major milestone served as a critical first step toward sustaining a vibrant and diverse network of community hub leaders and stakeholders whose collective interests are to make major inroads into systemic health care reform and the reduction of health/health care disparities. While each of the community hubs are independent entities with individual charters, their collective participation in Center activities supports efforts that promote dissemination and diffusion of innovative models, technologies, strategies, knowledge, products, and resources on effective community-based care coordination services.

     

     

  • What is Community Care Coordination and How is it Related to Pathways?

    There is very little agreement in the research community about what constitutes a scientific definition of care coordination and to a lesser degree—community care coordination. Examples of varying perspectives on the definition of care coordination emanate from such domains as disease management, case management, care management, transitional care among others. In fact, in an Agency for Healthcare Research and Quality (AHRQ) publication, Closing the Quality Gap: A Critical

    Analysis of Quality Improvement Strategies: Volume 7—Care Coordination, there are over 40 definitions of care coordination.  AHRQ defines care coordination as the deliberate organization of patient care activities between two or more participants (including the patient) involved in a patient’s care to facilitate the appropriate delivery of health care services.  Organizing care involves

    the marshalling of personnel and delivery of health care services.

     

    Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies: Volume 7—Care Coordination, Structured Abstract. Publication No. 04(07)-0051-7, June 2007. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/tp/caregaptp.htm

     

    The CCCLN asserts that community care coordination includes a focus on additional influencing factors within a patient’s environment and has adopted the following definition to guide its work.

     

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    Community Care Coordination is the process of identifying and engaging individuals within their community-home setting, assessing their health and social needs and connecting them to the health and/or social services they need.

     

    Community care coordination works to assist individuals in navigating and overcoming barriers in the space between their home and a wide range of institutional structures such as clinics, hospitals and human service agencies (e.g., public assistance, transportation services, medical assistance).  Community care coordination embraces a holistic approach to addressing physical, social, and behavioral determinants of health, which collectively are seen as integral to health care interventions necessary for achieving personalized care and improved outcomes. 

     

    Many of the tenets of the Pathways Model align closely with ecological models of health and community development.  That is, the Pathways Model embraces individual and community engagement, empowerment, collaboration, equity and sustainability. These same tenets are fundamental to health improvement and community development efforts.