Vulnerable populations

Innovations

Periodic, Nurse-Initiated Telephone Contact Provides Quality Followup Care to Infants With Lung Disease in Rural Areas 01/22/08

A nurse specialist maintains regular telephone contact with the primary caregivers and health care providers of premature infants with chronic lung disease who are discharged from the hospital.

Onsite Nurses Manage Care Across Settings to Increase Satisfaction and Reduce Cost for Chronically Ill Seniors 01/21/08

Specially trained nurses work with primary care physicians in their offices to improve the quality and efficiency of care for seniors with multiple chronic illnesses by coordinating care, facilitating transitions in care, and acting as the patient's advocate across health care and social settings.

Nurse-Led Assessment and Tailored Intervention Did Not Improve Adherence to Medication Regimens in HIV/AIDS Patients 01/18/08

A nurse-led program did not improve adherence to antiretroviral medications for patients with human immunodeficiency virus who are either homeless or live in marginal housing.

Wireless Messaging System Has No Impact on Blood Glucose Levels, but Patients Believe It Improves Quality of Care 01/17/08

The University of Washington Physician's Network developed a wireless, pager-based messaging system to help diabetic patients better manage their condition. An evaluation of the initiative found that it had no impact on blood glucose levels, although blood pressure improved.

Health Coach Program in a Medical Group Improves Self-Care and Decreases Readmissions for High-Risk, Chronically Ill Patients 01/17/08

Dartmouth-Hitchcock Clinic assigned health coaches to high-risk chronic disease patients to provide instruction regarding health care needs over the phone, during office visits, and in group classes; the program reduced readmission rates and costs among elderly patients.

Postdischarge Care Management Integrates Medical and Psychosocial Care of Low-Income Elderly Patients 01/16/08

An interdisciplinary care management program that integrates medical and social care for low-income elderly patients with chronic illnesses reduces care costs and improves self-reported health status.

Palliative Care Nurses in Primary Care Clinics Reduce Hospital Admissions, Increase Use of Hospice and Home Care for Patients Nearing End of Life 01/15/08

A partnership between a hospice organization and an 11-location multispecialty group practice places palliative care nurses in primary care clinics to monitor dying patients' medical and social care needs, coordinate community services, and discuss end-of-life issues.

Comprehensive Monitoring Pinpoints 911 Dispatch Inefficiencies, Leading to Communication and Deployment Improvements That Increase Cardiac Arrest Survival 01/15/08

A collaborative effort to develop an out-of-hospital cardiac arrest registry and change 911 call routing and ambulance deployment processes led to a significant improvement in the cardiac arrest survival rate in Atlanta.

Periodic Home Visits, Specialist Visits, and Followup Enhances Access and Improves Outcomes for Low-Income Children With Asthma 01/15/08

A pediatric asthma management program led to a significant decline in the percentage of patients with moderate to severe asthma, improved quality of life, and sizable decreases in hospitalizations and costs.

Mental Health Court Links Eligible Offenders With Treatment and Monitoring, Reducing Recidivism, and Improving Outcomes 01/15/08

The Brooklyn Mental Health Court links eligible defendants to long-term treatment and monitoring of their mental health problems as an alternative to incarceration. Early evidence suggests that the program has been successful in reducing recidivism, homelessness, psychiatric hospitalizations, alcohol use, and substance abuse.

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