Chronic care

Innovations

Community Health Workers Known as Promotores Enhance Access to Culturally Tailored Services for Elderly, Low-Income Racial/Ethnic Minorities, Leading to Improvements in Mental Health 12/05/13

Community health workers known as promotores enhance access to culturally competent mental health education and services, leading to improvements in mental health status and literacy for elderly racial and ethnic minorities.

Foundation Develops Community-Based HIV Testing and Partnerships With Medical Homes, Leading to More Timely Linkages to Care for Newly Diagnosed Patients 11/25/13

A local foundation developed community-based testing programs and partnerships with medical homes to provide real-time linkages to HIV care to newly diagnosed patients and to support these patients in transitioning to care, nearly doubling the number of patients initiating treatment.
 

Citywide Collaborative Implements Multiple Initiatives That Reduce Appointment Wait Times, Readmissions, and Emergency Department Use for Low-Income Minority Patients 11/10/13

A public–private urban health partnership develops multiple initiatives to expand access to high-quality, coordinated health care for vulnerable residents, leading to shorter wait times for appointments, improvements in patient–provider continuity, and reductions in readmissions and emergency department use.

Medical Home for Patients With Disabilities and Chronic Conditions Improves Access and Self-Management Skills, Leading to More Healthy Days, Fewer Hospitalizations 11/04/13

A primary care medical home for patients with disabilities and complex, chronic medical conditions emphasizes patient engagement and care coordination among medical specialties and social service providers, leading to enhanced access to care, better self-management skills, more days of good health, fewer hospitalizations, and lower costs.

Social Workers Support Outpatients in Dealing With Psychosocial Issues, Leading to High Patient and Practitioner Satisfaction and Better Patient Self-Management 10/21/13

Master's-level social workers operating out of a centralized department support primary care and specialty clinic patients in dealing with psychosocial and environmental issues, leading to high levels of patient/caregiver and practitioner satisfaction, improvements in patients' well-being and self-management skills, and reductions in resource use.

Hospital Uses Data Analytics and Predictive Modeling To Identify and Allocate Scarce Resources to High-Risk Patients, Leading to Fewer Readmissions 08/13/13

A safety net hospital employs a software application that uses electronic health record data and predictive modeling to identify and allocate scarce resources to high-risk patients, leading to fewer readmissions and lower costs.

Clinics Offer Culturally Tailored Diabetes Education and Culturally Appropriate Care to Ethiopian Patients, Leading to More Engagement, Better Outcomes, and Reduction of Health Disparities 07/29/13

A large health plan offered a 6-month program featuring culturally tailored educational classes and materials and the integration of culturally sensitive approaches into everyday care, leading to increased cultural sensitivity among staff, more engaged patients, and better health outcomes, and contributing (along with other programs) to the elimination of racial disparities.

Adding Diabetes and Hypertension Screening to Oral Health and Hygiene Program Identifies Many Seniors With or at Risk for These Chronic Illnesses 07/17/13

As an expansion to an existing community-based oral health program for Hispanic and African-American seniors, dental school faculty, staff, and students offer education and screening for hypertension and diabetes, leading to the identification of many seniors with or at high risk for these chronic illnesses and many previously diagnosed individuals who do not have the condition(s) under control.

Financial Incentives and Education Do Not Help Patients Better Manage Hypertension or Reduce Racial and Ethnic Disparities in Management of the Disease 06/20/13

The combination of a small financial incentive and patient education leads to a modest, short-lived increase in physician visits, but has no effect on blood pressure control or on racial and ethnic disparities in management and control of hypertension.

Community-Based, Culturally Tailored Diabetes Education Program Helps Low-Income South Korean Immigrants Improve Self-Management Behaviors, Disease Control, and Other Health Markers 06/10/13

A low-cost, community-based, culturally tailored education program led by a bilingual nurse practitioner helped Korean immigrants with type 2 diabetes improve self-management behaviors and achieve better control of the disease.

Pages

Subscribe to Chronic care

This website is certified by Health On the Net Foundation. Click to verify. This site complies with the HONcode standard for trustworthy health information: verify here.