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Post-Acute Care Case Examples
The Section for Long-Term Care & Rehabilitation has identified examples of members who have shared successful Post-Acute Care strategies and best practices that they have implemented to enhance care coordination, improve patient-centered care, achieve better patient outcomes, and improve their operational and financial performance.
For more information on each of these examples, please contact the institutional contacts listed. And, if you have examples that you would like to share, please contact Shawna Brown at 312/422-3309 or click here to submit an email.
The Implementation of the ICD-10 Guidelines and the Impact for PAC Providers, June 8, 2011
Boston Medical Center - Boston, Massachusetts
Re-Engineered Discharge Process
Care Transitions Quality Improvement Organization Support Center (QIOSC)
The Use of Community-Based-Interventions to Reduce 30 Day Readmissions: The Good, the Bad, the Ugly. Presented by the Alabama Quality Assurance Foundation, Care Transitions Team - Birmingham, AL, January 27, 2011 Conference Call
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Dianne M. Richmond, RN, MSN, APN, Care Transitions Theme Lead
Sherrie Smith, RHIA, CPHQ, Quality Resource Specialist
Rashaan Anderson, PhD, MSPH, BS, Quality Resource Specialist
Nikki Bell-Johnson, RN, BSN, Quality Resource Specialist
Patricia M. Richetto, RN, BSN, MSN, Quality Resource Specialist
Christiana Care Visiting Nurse Association and Delaware Physicians Care Inc.
Learnings from a Pilot Partnership with a Managed Care Medicaid Organization
September 19, 2011 Member Conference Call
HealthEast Care System – St. Paul, Minnesota
Care Navigation Strategy
May 29, 2009 Member Conference Call with HealthEast Care System:
HealthEast Care System - St. Paul, Minnesota
Reducing MRSA Rates in Post-Acute Care through Hand Hygiene and Body Substance Isolation Practices
Rehab Hospitals Retooling, Joe Cantlupe for HealthLeaders Media, April 25, 2011
HealthSouth Rehabilitation Hospital of Toms River - Toms River, New Jersey
Interdisciplinary Acute Care Transfer Process/Review;
Holy Family Medical Center - Des Plaines, Illinois
Reducing Long Term Acute Care Hospital (LTACH) Central-Line Associated Bloodstream Infection (CLABSI) Episodes
Madonna Rehabilitation Hospital - Lincoln, Nebraska
Madonna ProActive Structured Independence Program
Magee Rehabilitation Hospital - Philadelphia, Pennsylvania
“Zapping VAP (Ventilator-Assisted Pneumonia)”: Eliminating VAP in Spinal Cord Injury Patients
Palmetto Health: Building a Firm Foundation: How PACE Enabled Palmetto Health to Develop Their ACO, December 12, 2011
Partners HealthCare and Partners Continuing Care - Boston, Massachusetts
Partners HealthCare's Continuing Care Network: Building Foundations for Bundling,
January 26, 2011 Member Conference Call
RML Specialty Hospital - Hinsdale, Illinois
Reducing Hospital-Acquired Clostridium difficile Transmission Rates
Sheltering Arms Rehabilitation Hospital, Mechanicsville, Virginia
“Weekly Business Drivers – Operating Improvement Process"
July 16, 2009 Member Conference Call with Sheltering Arms Rehabilitation Hospital:
St. Luke's Rehabilitation Institute - Spokane, Washington
Improving Rehabilitation Care through Technology and Collaboration
Valir Rehabilitation Hospital - Oklahoma City, Oklahoma
Using Patient- and Family-Focused Care to Achieve Positive Outcomes and Negotiate Favorable Reimbursement Rates
Innovations from the Agency for Healthcare Research and Quality – Rockville, Maryland
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UPDATED: House Calls to Frail Elders Reduce Costs, Hospital Use, and Nursing Home Placements
An interdisciplinary team of geriatricians, nurse practitioners, and social workers provide primary health care via house calls to homebound frail elders
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UPDATED: Nursing Home Learning Collaborative Improves Quality of Care, Reduces Staff Turnover
In an approach to improving nursing home care known as the "Wellspring Program," nursing homes join an alliance that allows participants to exchange performance experience and conduct interdepartmental group training for both front-line staff and leadership on quality improvement and culture change processes