Implementing a care coordination strategy for children with medical complexity in Ontario, Canada: a process evaluation

Samantha Quartarone, Jia Lu Lilian Lin, Julia Orkin, Nora Fayed, Simon French, Nathalie Major, Joanna Soscia, Audrey Lim, Sanober Diaz, Myla Moretti, Eyal Cohen*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)
39 Downloads (Pure)


Introduction: A provincial strategy to expand care coordination and integration of care for children with medical complexity (CMC) was launched in Ontario, Canada in 2015. A process evaluation of the roll-out examined the processes, mechanisms of impact, and contextual factors affecting the implementation of the Complex Care for Kids Ontario (CCKO) intervention strategy.

Methods: This process evaluation was conducted and analyzed according to the United Kingdom Medical Research Council (UK-MRC) process evaluation framework. To evaluate the implementation of the CCKO intervention, a multi-method study design was used, including semi-structured interviews with 38 key informants and 10 families of CMC involved in CCKO. To further understand implementation details across regional sites, provincial-level implementation plans, and process documents were reviewed.

Discussion: Strengths of CCKO included novel collaborations and partnerships between complex care teams, community partners and regional sites. Issues relating to communication and coordination across care sectors created challenges to holistic care coordination objectives. Provincial system fragmentation limited the ability of CCKO to provide seamless care coordination due to the multiple care sectors involved.

Conclusion: This study adds to the understanding of the processes involved in a population-level care coordination intervention for CMC. Lessons learned through CCKO can help facilitate reproducibility and necessary adjustments of the intervention in different settings.

Original languageEnglish
Article number9
Pages (from-to)1-14
Number of pages14
JournalInternational Journal of Integrated Care
Issue number2
Early online date28 Apr 2022
Publication statusPublished - 2022

Bibliographical note

Copyright the Author(s) 2022. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


  • process evaluation
  • care coordination
  • complex care
  • medical complexity
  • child
  • family


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