A community-based primary care clinic uses nurses to provide culturally competent care coordination to Latino patients with chronic illnesses and disabilities, leading to greater provision of recommended care, lower health care costs, and enhanced self-management capabilities.
A fall prevention program for seniors who receive home care uses a 12-element assessment tool to identify risk factors for falls and then develops specific interventions designed to reduce these risks; ongoing monitoring of medications and periodic reassessments help to support the effort.
The El Rio Inner-City Asthma Intervention Program is a comprehensive bilingual, bicultural program that primarily serves low-income, inner-city Latino children with moderate or severe persistent asthma.
Reconciling patient and provider medication lists reduces discrepancies, leading to enhanced medication safety and high levels of patient and provider satisfaction in the outpatient setting.
A health maintenance organization integrated mental and behavioral health care and nutrition services with primary care delivery, leading to a more than 50-percent reduction in mental health–related hospitalizations.
The Pathways Model employs community health workers who connect at-risk individuals to evidence-based care through the use of individualized care pathways designed to produce healthy outcomes; implementation of this model in Richland County, OH, resulted in increased services to at-risk women and a decline in the rate of low birth weight babies.
Group prenatal and parenting classes integrate health assessment, education, and support, leading to improved birth outcomes and enhanced provider efficiency.
The Partners in Pregnancy program combines telephone-based case management with periodic home visits from registered nurses and community-based workers to improve pregnancy outcomes for high-risk pregnancies in a Medicaid managed care population.
A hospital's ambulatory pediatrics department developed a voluntary, anonymous, and nonpunitive medical error reporting system that includes a quick response team to review reports and enact interventions to prevent recurrences, leading to a significant increase in error reporting.
The Washoe County School District in Reno, NV, developed a worksite wellness program that promotes personal responsibility for health by offering fun and creative wellness programs and instituting a monthly payroll deduction that is waived if the employee meets certain screening criteria.