Discharge Planning
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Ways to Improve Communication Among Care Teams and Patients/Parents
Provider and patient or family conversations often take place in ICUs and other settings where patients and family members may experience high levels of stress, anxiety, and depression. Communication challenges can contribute to their stress, particularly when the patient is a child, research shows.
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Care Continuum Collaboration Improves Heart Failure Patient Care
A focus on multidisciplinary management of heart failure patients, along with transitional care interventions and integration with post-acute care facilities, can lower 30-day readmission rates for heart failure patients, new research shows.
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Nurse Care Coordinators Are Valuable in Federally Qualified Health Centers
A Federally Qualified Health Center that invested in a registered nurse care coordination program in a primary care setting found the position provided a valuable service and was cost-effective.
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Communication Challenges Affect Discharge Planning
Obstacles to effective care transitions include communication problems, both inside and outside the health system, according to researchers. When providers were asked about their communication concerns, they cited too many methods of communication, a high volume of communication, and challenges communicating with multiple providers and those outside their health system.
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Maternal Health Reaches a Crisis Point in the United States
The number of women dying from pregnancy-related causes in the United States has risen dramatically since 2018. Those numbers may continue to rise sharply as the nation creates more maternity deserts, obstetric staffing shortages, and obstacles to standard maternity care in states that enforce abortion bans and restrictions that affect women experiencing pregnancy crises.
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ET3 Pilot Hailed as Big Step Toward Fully Leveraging EMS
In January 2021, the Centers for Medicare & Medicaid Services launched a five-year pilot program called Emergency Triage, Treat, and Transport (ET3), an approach that enables participating EMS programs to connect some patients with lower-acuity problems to emergency providers via telemedicine at the scene. Most participants are excited about leveraging the approach to accelerate needed care to patients, decompress EDs, and maximize the skills of the EMS workforce.
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Remote Facilities Can Avoid Unnecessary Pediatric Transfers by Leveraging Telemedicine
When critically ill children present to EDs in rural or community hospitals that lack access to specialty pediatric care, the solution often is to transfer them to a regional pediatric facility, which could be hours away from a patient’s home. This creates travel burdens and added expense for families and payors. But new research suggests that at least some of these interfacility transfers can be safely avoided by incorporating telemedicine consultations with pediatric specialists.
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Care Collaboration Helps Patients with At-Risk Heart Failure Illness
Researchers found social support and care affordability are important to obtain better outcomes among patients with heart failure and reduced ejection fraction.
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A Guide to Training Nurses on Transitional Care
It is challenging to find a tailor-made educational and training program for registered nurses to learn transitional care. A VA hospital created its own program, called the Transitions Nurse Training Program.
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Care Coordination Training Works Well for VA Hospitals
One of the challenges facing health systems as patients are moved from the hospital to another healthcare facility is how to make these transitions as safe as possible — especially in rural and underserved areas. A Veterans Affairs hospital has found a possible solution through its Transitions Nurse Training Program.