Acute on chronic care (i.e., an acute condition resulting from underlying chronic disease)
A school district's multifaceted, collaborative initiative to reduce the impact of asthma includes multiple policies and subsequent programs such as electronic monitoring, case management, and stakeholder-specific education, leading to fewer asthma-related absences and better academic performance, behavior, health, and quality of life for students with asthma.
Case management combined with in-home environmental assessment and remediation of environmental triggers reduce asthma-related hospitalizations, emergency department visits, missed school days, and missed parent work days in diverse, low-income urban children with asthma.
A comprehensive initiative to improve stroke care features protocols to facilitate faster evaluation and diagnosis, quick administration of tissue plasminogen activator when indicated, 24-hour access to a neurologist, enhanced discharge planning, improved documentation and data collection, continuous staff training, and community outreach, leading to more timely administration of appropriate diagnostic tests and treatment and to many more eligible patients receiving tissue plasminogen activator.
A separate emergency center for older patients includes physical features to reduce anxiety and discomfort, staff trained in geriatric care, and routine followup monitoring after discharge, leading to high levels of patient satisfaction, detection of polypharmacy, increased patient volume, and a low rate of return visits.
A trained nurse educated other nurses, physicians, and administrators on evidence-based heart failure treatment and provided disease management education and followup support to high-risk patients, leading to fewer readmissions and lower costs.
Langley Porter Psychiatric Hospital and Clinics used Toyota Production System principles to streamline the process by which patients are transferred to outpatient clinics, significantly reducing scheduling time, time to the patient's first appointment, and communication errors, and leading to a near doubling in the number of patient transfers.
A comprehensive program to improve patient experience before, during, and after orthopedic surgery leads to improved satisfaction, higher patient volume, and better patient outcomes.
The Medical Outreach Program enhanced services provided to unstably housed, minority individuals with human immunodeficiency virus by including physicians on the community outreach team who provide general medical consultation, triage, acute care, evaluation, and prescriptions for needed medications.
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 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.