Connecting Care - Improving Quality

Matching patients with primary care physicians was top priority of this project improvement by the care team at Northwestern Memorial Hospital, Chicago.

Detailed data analysis by the team at Northwestern Memorial Hospital, Chicago, revealed that patients often readmit or return due to a lack of timely follow-up care and a lack of access to appropriate outpatient care management. The team decided to develop a care model that aimed to improve the quality of discharge transitions after an inpatient stay or emergency department visit. This led to two goals:

Ensure that all patients receive access to outpatient care within seven days of discharge and
Ensure that all patients have a primary care physician

A standardized follow-up appointment scheduling process was introduced to provide patients access to outpatient care within seven days of discharge. For those patients without an established primary care physician, a follow-up clinic, open three days a week, was opened in December 2011 to stabilize patients, address psychosocial needs and bridge patients into a new medical home. The clinic expanded operations to five days a week in April 2013. Patients seen in the clinic have demonstrated a 37.5 percent reduction in 30-day ED return rates and 35.6 percent reduction in 30-day inpatient readmission rates compared to those patients scheduled but not seen in the clinic. Read the whole case study below (click 'view item').

This case study is part of the Illinois Hospital Association's annual quality awards. Each year, IHA recognizes and celebrates the achievements of Illinois hospitals in continually improving and transforming health care in the state. These hospitals are improving health by striving to achieve the Triple Aim--improving the patient experience of care (including quality and satisfaction); improving the health of populations; and reducing the per capita cost of health care.

Award recipients achieve measurable and meaningful progress in providing care that is:

(The Institute of Medicine's six aims for improvement.)

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