Transition Home Program Reduces Readmissions for Heart Failure Patients
The Transition Home program incorporates a number of components to ensure patients a safe transition to home or another health care setting, leading to fewer readmissions.
Alerts, Standing Orders, and Care Pathways Boost Quality of Care for Pneumonia, Heart Attack, and Heart Failure
Reid Hospital created a computer-based system of alerts, standing orders, and care pathways to eliminate gaps in the care of patients with pneumonia, acute myocardial infarction, and heart failure, and to address surgical complication and infection prevention, leading to significant improvements in quality of care.
Chronic Care and Disease Management Improves Health, Reduces Costs for Patients With Multiple Chronic Conditions in an Integrated Health System
The Sutter Care Coordination Program combines chronic care and disease management to address the medical and psychosocial needs of individuals with multiple chronic conditions.
Medical Center Establishes Infrastructure to Manage Care Under Capitated Contracts, Leading to Better Chronic Care Management and Lower Utilization and Costs
A university hospital established an infrastructure based on the principles of an accountable care organization, leading to improved management of chronic disease and reduced hospital admissions and medical expenses.
Standardized Tools and Protocols Increase Provision of Recommended Care in Key Clinical Areas, Reducing Hospital Mortality
A hospital implemented new processes to increase the provision of recommended care for heart failure, acute myocardial infarction, pneumonia, and surgery patients, leading to significant improvements in quality and a 25 percent reduction in mortality.
STate Action on Avoidable Rehospitalizations (STAAR) Materials
The STate Action on Avoidable Rehospitalizations (STAAR) Initiative of the Institute for Healthcare Improvement and The Commonwealth Fund aims to reduce avoidable rehospitalizations. This Web site features guides, presentations, and other tools related to reducing readmissions.
Expecting Success Toolkit
The Expecting Success Toolkit provides tips for hospitals on improving the quality of care and reducing disparities.
Heart Failure Self-Management—Caring for Your Heart: Living Well With Heart Failure
These health communication aides for clinicians can help them demonstrate to patients that organized self-management support can improve self-care behaviors and prevent hospitalizations.
Develop Your "Hospital At Home" Program
"Hospital At Home" is an innovative health care model that can provide hospital-level care in a patient’s home as a full substitute for acute hospital care until the patient is ready for discharge to their primary care physician. The Web site contains information and tools for organizations that are considering starting their own program.
Treating Congestive Heart Failure With Beta Blockers: What You Can Do To Make Yourself Feel Better
This brochure can help patients and their families understand congestive heart failure and current treatments, focusing on the use of a group of medications called beta blockers.