Preventive care processes
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.
Meadowlark Hills, a retirement community, renovated one of its facilities so residents can live together in group households and become more independent. This led to improved residents' health and a sharp decrease in staff turnover.
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.
Cambridge Health Alliance enhanced its round-the-clock interpreter services by tracking key indicators that gauge the quality of these services; analyses of these data led to significant improvements in the program's telephone-based services and staff efficiency and the decision to implement depression screening in patients with limited English proficiency.
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.
Providence Mount St. Vincent (known as “The Mount”) developed and implemented a new model for nursing home care in which most residents live in a “neighborhood” of 20 to 23 residents; neighborhoods contain a cluster of private and semiprivate rooms and a large kitchen/dining area that serves as the central gathering spot for meals and activities. The Mount's approach also focuses on giving residents more independence, autonomy, and dignity than in a traditional nursing home, leading to a greater sense of community and a higher quality of life for residents, as well as a better work environment for employees.
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.