Initially, KP thought that the Chronic Care Coordination (CCC) RNs should not be located in clinics due to concerns that the nurses would get pulled into other clinic responsibilities.  However, this had negative consequences for internal relationships and collaboration with clinic staff.  Now the CCC RNs  are located in the clinic and can easily collaborate with other staff.

Although the CCC nurses work over the phone, they have found that they build very strong relationships with the patients.  Many of these patients will periodically call a CCC nurse when they have questions or a health care issue even after they have been discharged from the program.

KP Colorado is now focusing on helping RNs prioritize their patients and patient needs, along with time management.  While most RNs are trained to give their all to the patient in front of them, Chronic Care Coordination requires effectively reaching out to patients in their homes.

KP holds Chronic Care Coordination meetings across facilities in the region each month to help the different locations learn from each other.  In addition, CCC Coordinators work with the relevant local caregivers and resources (e.g. diabetes managers).