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Designing a Program

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Post Reducing Readmissions
Author: Weissman [CAPC/PCLC Faculty]
Date: Jan 11, 2012 9:40 am
The Institute for HealthCare Improvement is seeking:
seeking experience and ideas from organizations that have successfully reduced readmissions for people with advanced illness. When people are at advanced stages of their illness and leave the hospital, how can health care providers deliver care that helps them stay out of the hospital? This could be from a hospital or health system perspective. We are curious about how you defined the population, what changes you made, what obstacles you had to overcome, and how you track your progress. We would be grateful for any insights.

Please respond to David Weissman, MD, CAPC Consultant at dweissma@mcw.edu
Replies: order by [Date] [Author] [Subject]
Re:Reducing Readmissions (by Kathi on 01/11/2012)
This is the ongoing dilema, I believe, for all of us. It appears to require a strong system of community support for patients and caregivers working in partnership with hospitals. How this can be achieved is a work in progress and I too would be interested in hearing from anyone who feels they are getting a handle on this issue.
Re:Reducing Readmissions (by Kathi on 01/11/2012)
This is the ongoing dilema, I believe, for all of us. It appears to require a strong system of community support for patients and caregivers working in partnership with hospitals. How this can be achieved is a work in progress and I too would be interested in hearing from anyone who feels they are getting a handle on this issue. Has anyone ask the stakeholders?
Re:Reducing Readmissions (by BobW on 01/29/2013)
I have had a successful In Home Palliative Care program in Phoenix Arizona. It was proven from Hospitals that have a palliative care program in house, noticed that after referring to our company, that the patients were not coming back to the hospital for re-admissions. If you are sending in physicians and or Nurse Practitioners to take care of the Senior Adults Chronic illness then they will not fall through the cracks in their health care journey.

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