The Indiana Complex Care Coordination Collaborative (IC4) Technical Assistance Center is a transdisciplinary team of skilled nurse care coordinators, social workers, clinicians, researchers and patient and family representatives. The team’s collective expertise trains and supports new and curious care navigators, managers and coordinators to improve their delivery of patient-and-family-centered “whole person” care.
Targeted curricula currently focus on serving children with chronic health conditions or medical complexity (CMC) and/or adults with intellectual or developmental disabilities (AIDD).
Resources and Services
Care coordinator coaching curricula to promote job success and satisfaction and the professional advancement of care coordination as a field of work.
- The structured orientation and high-intensity didactic series accelerate acquisition of care coordinator skills.
- Individualized coaching methods include case discussions, care plan auditing, quality indicator reporting and competency-based milestone assessment.
- The up-to-date fingertip resource library facilitates navigation of health systems and government and community services.
- The longitudinal community of practice continues opportunities for shared learning, synthesis and problem-solving.
Patient and family engagement models to apply patient/family-centered principles at all levels of the program.
- Patient and family representatives contribute as professional members of the leadership team and advisory groups.
- Curricular content reflects paired creation and delivery by professional and parent trainers.
- Trainees incorporate individualized family support goals as a key component in each patient’s plan of care.
- Family receiving care services participate in satisfaction surveys and focus groups to identify strengths and areas for improvement.
- Ongoing strategic planning engages families in partnership through the Title V collaboration with IN Family Colleagues Transforming Systems (IN-FaCTS)
- IC4 offers training and delivers Parent Café events as structured, small-group conversations among caregivers, using the Be Strong Families model.
Primary care team support and education to build advanced medical home skills in chronic care management for children with medical complexity and accommodative healthcare inclusion for adults with intellectual/developmental disabilities.
- Frontline clinical tools for care management are available through a public website and a university-based learning platform.
- Learning collaboratives explore skill-building, improved efficacy and job satisfaction while affording participants continuing education and maintenance of certification credits.
4ourhealth is a patient-facing website designed to improve health and well-being in persons with intellectual and developmental disabilities (IDD). Built in partnership with Special Olympics Indiana, the website offers learning opportunities in healthy living, navigating the health system and managing chronic conditions.
- Easy-read info, videos, games and worksheets are prioritized for persons with IDD.
- Extra tips for caregivers are highlighted at the bottom of pages.
- Resources for clinicians are linked in the bottom banner.
My Story app from Cloud Forest Solutions is the electronic platform that delivers shared plans of care across each patient’s care neighborhood.
- A shared plan of care is a collaborative document created by a patient, family and their entire care team to provide a unified, comprehensive overview of the person's health needs, goals and treatment.
- The app aggregates and displays up-to-date, real-time information about a patient’s health status and history for sharing between care support professionals, families and delegated care team members.
Aligned Care Support Network is an Indiana Title V-funded project that connects cross-sector professionals working with families to improve both access to services and quality of care for children and families.
- Delivers an asynchronous, virtual education program with progressive levels of digital badging in patient/family-centered care, relational teamwork and collective accountability.
- Expands communities of practice to healthcare and social service organizations to sharpen participating professionals’ abilities to deliver targeted, efficient and effective outcomes which meet the needs and goals of every child and family they serve.