CYSHN Systems Integration Project - CYSHN

Mapping Care Coordination for Children in Minnesota

In Minnesota, a systems mapping process, which gathered input from stakeholders from across the state, was undertaken to assess strengths, challenges, gaps, and redundancies that are occurring around care coordination.

Background Information:

Children and youth with special health needs and their families often need a wide variety of medical, psychosocial, educational, and support services. Without effective care coordination, CYSHN can receive fragmented or duplicative services - ultimately receiving less than optimal care and causing unnecessary stress and frustration for families. In order to improve care coordination for CYSHCN, stakeholders need to have a better understanding of current cross-system care coordination efforts.

What did we do in Minnesota?

During 2015 - 2016, we conducted a series of regional meetings across the state with stakeholders involved in providing or receiving care coordination. The specific objectives for these regional meetings included:

  • Discuss greatest opportunities and challenges in coordinating care;
  • Gain understanding of the complexity of care coordination from the family's perspective;
  • Complete system mapping to identify current organizations and initiatives supporting the care coordination system, identify current gaps and redundancies in the system, and guide systems improvement efforts;
  • Develop and prioritize recommendations to improve care coordination;
  • Brainstorm ideas on ways each participant can improve how they practice care coordination;
  • Discuss and plan for ways that care coordinators can collaborate and/or continue working with each other to improve care coordination in their region.

What were our findings?

Regional and state-level findings from our systems assessment are included in the reports linked below: