Cooperation and coordination around children with individual plans

Abstract

In this article we discuss the relationship between cooperation and coordination around six children with special needs who attend Norwegian day care centres. The children in focus have 'individual plans', in which goals, roles and activities at the centre of the cooperation are documented, and are as such a coordinating device. Each child has a cooperative team consisting of parents, representatives from day care centre, the child's special educator, the public health nurse and, for instance, their physiotherapist, family doctor etc. to support them. The cooperating teams are headed by a coordinator, who in most cases is the public health nurse. Methods used in the study are individual interviews with at least four representatives from each cooperative team, as well as two focus group interviews with representatives from two different specialist units. The research design is action oriented, and involves, in addition to data collection, two seminars with parents and practitioners from the day care centre and social/health sectors. Departing from the empirical findings in the project we discuss how the coordinating practices, such as the individual plan and the designation of coordinators, influence the cooperation in the teams around each child. Our findings indicate that cooperation benefits from a bottom-up process, in which it is the cooperation that structures the coordination, rather than vice versa.

Comprehensiveness, Coordination and Continuity in Services Provided to Young Children with Cerebral Palsy and Their Families in Norway

“…This difference is notable because the coordinator is assigned the responsibility for the planning and follow-up for the ISP (Norwegian Directorate of Health, 2015). The discrepancy between reporting having a coordinator and the other types of coordinating services may be substantial; however, it could also be seen an under-reporting due to unclear boundaries and overlapping roles, for instance, when the child's physiotherapist also holds the role of coordinator (Appleton et al, 1997), as has been identified as a problem in previous studies (Hannigan et al, 2018;Alve et al, 2013;Nilsen & Jensen, 2012).…”

“…Interruptions were surprisingly widespread among coordination services, being identified in one-third of the families with a multidisciplinary support team, more than half of the families with an ISP and more than two-thirds of the families with a service coordinator. Previous research has revealed multiple barriers when service coordination is to be implemented in healthcare (Hannigan et al, 2018;Holum, 2012;Nilsen & Jensen, 2012). In a Norwegian context, one previously identified challenge is the ISP ultimately becoming a "desk document" instead of a "live document" (Nilsen & Jensen, 2012).…”

“…Previous research has revealed multiple barriers when service coordination is to be implemented in healthcare (Hannigan et al, 2018;Holum, 2012;Nilsen & Jensen, 2012). In a Norwegian context, one previously identified challenge is the ISP ultimately becoming a "desk document" instead of a "live document" (Nilsen & Jensen, 2012). The existence of an inactive plan may explain why some parents did not report having an ISP in the six months preceding an assessment.…”

“…The existence of an inactive plan may explain why some parents did not report having an ISP in the six months preceding an assessment. Challenges are also reported regarding the implementation of a service coordinator (Nilsen & Jensen, 2012). In some cases, the coordinator does not have sufficiently in-depth knowledge of the child and family situation or is not actively involved in the regular follow-up, leading to more irregular and infrequent encounters with the families (Nilsen & Jensen, 2012).…”

Planning individually? Spotting international welfare trends in the field of rehabilitation in Norway

“…For many people in a rehabilitation process, the individual plan has proved very useful (Thommesen, Sandvin, and Normann 2003). However, recent research has proved that there are various challenges with the use of the individual plan (Alve et al 2013;Hansen 2007;Nilsen and Jensen 2012;Nilssen 2011;Røthing 2007;Slettebø et al 2012). This article will describe some unintended forms of use that are not in line with the original intentions, and illustrate how this is in accordance with international welfare trends.…”