Community Care Coordination
Community Care Coordination Wednesday, September 15, 2010
Identifying at-risk individuals and connecting them to appropriate care can improve health outcomes and reduce health disparities. Community care coordination aims to improve the quality, efficiency, and coordination of health care and social services for at-risk populations. Such programs often use community health workers or navigators to help coordinate services.
The featured Innovations describe three programs that used the Pathways© model of community care coordination to connect at-risk individuals to needed services, thereby improving health outcomes.
The featured QualityTools provide resources that can assist communities in their efforts to improve the quality and coordination of health care services.
- Program Uses "Pathways" to Confirm Those At-Risk Connect to Community Based Health and Social Services, Leading to Improved Outcomes
- Care "Pathway" Connects Pregnant Substance Abusers to Medical and Other Services, Supporting Birth of Babies with Viable Weights Who Are Free of Illicit Substances
- Community Health Navigators Use Pathways Model to Enhance Access to Health and Social Services for Low-Income, At-Risk Residents
Also in This Issue:
- Community Health Collaborative Reduces Inappropriate Emergency Department Use by Providing Access to Health Care, Social Support for Low-Income Clients
- Hospital Provides Non-English-Speaking Patients With Recording of Discharge Instructions in Native Language, Leading to Improved Comprehension and High Satisfaction
- Six-Month Weight Management Program for African-American Women Church Congregants Improves Behaviors, Blood Pressure, and Body Mass Index
- Multiagency Collaborative Helps Community-Dwelling Seniors Access Coordinated Support Services, Helping Them Remain in Their Homes
- Health Clinics and Community Organization Coordinate Outreach Workers To Educate and Support Farm Workers, Leading to Healthier Behaviors and Higher Satisfaction
- Quality Improvement Collaborative Helps Clinic Serving the Uninsured to Significantly Increase Colorectal Cancer Screening and Smoking Cessation Education
- Community Partnership Uses Lay Health Advisers to Reduce Chronic Disease Risk Factors, Leading to Improvements in Lifestyle and Health in Low-Income African Americans