Identified Barriers to Success and Recommendations

Analysis of information collected through focus groups demonstrated that potential barriers to implementation of guidelines included fear of rigid application, a disconnection between co-ordinators and service providers, need for staff buy-in, increased paperwork, and high caseload sizes. To address these concerns, the guidelines were emphasized as a supportive tool with scheduled service reviews to foster greater communication among co-ordinators and service providers. Staff buy-in was achieved through inclusion of staff in the development process, a pilot implementation, and continuous feedback. Paperwork was kept to a minimum through the addition of only one new activity tracking form and one service provider form. High caseload sizes were taken into consideration by tracking only a small portion of clients at any given time. Parameters for how urgently assessments should be done were also added, as clients identified this as an important aspect.

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In summary, we recommended that guidelines for case co-ordination are necessary to ensure consistency and quality of service delivery. Guidelines must be based on actual practices and available resources, not preferred arbitrary standards. Guidelines must be flexible to allow for variation within need levels, but not be as wide in range as to be meaningless in setting expectations for service delivery. Development of effective guidelines also requires the involvement of case co-ordinators, clients, service providers, and decision makers. Finally, by gathering information about case co-ordination, a better understanding and appreciation of the nature and importance of case co-ordination is achieved by clients, service providers, and decision makers.