The cross-sector model of care: A work design perspective

Diagnosing and coordinating care for children with rare diseases is challenging. Whilst the care coordination literature and practice has focused on coordination within the healthcare system, less attention has been given to the coordination of the children’s and families’ lives across sectors including health, education, disability care, financial welfare and social support. The Cross-sector Model of Care at the Rare Care Centre, Perth Children’s Hospital, Western Australia, is a novel approach towards a holistic care coordination for patients with rare and undiagnosed diseases and their families across these multiple agencies. With the aim to evaluate the work structures of the Cross-sector Model of Care, we apply the SMART Model of Work Design and conducted 18 interviews with all team members at the Rare Care Centre. The results from the qualitative analysis show that work at the Rare Care Centre seems to be well designed, providing team members with a work structure that includes stimulation, job mastery, autonomy, social support and tolerable work demands. We also identified enablers (i.e., upskilling between experts, flexible role adjustment, autonomy, weekly meetings, maximum number of patients seen) and challenges (i.e., unclear role expectations, high individual responsibility, growing external demand) of the existing work design. By identifying key factors that determine successful holistic care coordination, this research can assist practitioners aiming to create care coordination teams.