Transitions between settings
A pediatric center provides comprehensive, coordinated services within a primary care medical home for low-income and immigrant children with special health care needs.
A randomized clinical trial at San Francisco General Hospital used visual medication schedules and brief teach-back protocols in English, Spanish, and Cantonese to improve anticoagulant control among low-literacy patients in the public hospital's anticoagulation clinic.
The University of Michigan Health System redesigned the process for activating its acute myocardial infarction team, with an emphasis on the earliest possible electrocardiogram administration and team activation, ideally while the patient is en route to the hospital.
Bridge to the Future provides nursing home visits to low-income families with medically fragile infants who have been discharged from the neonatal intensive care unit, thus ensuring a smooth transition to long-term care in the home.
Transitions coaches encourage recently hospitalized Medicare patients with complex care needs to assert a more active role in their posthospital care, leading to fewer readmissions and lower costs.
Community partnerships and provider training increase service capacity and access to long-term treatment for individuals addicted to heroin.
Multidisciplinary teams implemented a comprehensive medication reconciliation program for patient admissions, transfers, and discharge to significantly improve the reconciliation process.
The Re-Engineered Discharge project at Boston Medical Center standardizes the hospital discharge process through use of 11 separate but mutually reinforcing steps that health care professionals follow from patient admission to postdischarge.
A comprehensive hospital program that includes standardized protocols and various support systems to encourage adherence to these protocols led to an 81-percent decline in serious narcotic oversedations.
Mayo Clinic researchers developed a medication reconciliation intervention program for outpatient primary care settings that improved the accuracy of medication lists in the practice's electronic medical records.