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OSF deploys care transition program, reduces readmission rate from 29% to 9%

Healthcare It News

OSF HealthCare, a health system that serves Illinois and Michigan, had a big challenge: Managing the high rate of patient readmissions from hospitals to skilled nursing facilities and eventually to home care. THE PROBLEM This issue stemmed largely from gaps in continuous care during transitions between these settings.

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Fixing The Hospital-To-Home Health Care Transition

Home Health Care

Patients aged 70 and older – who qualified for home health services – were included in the pilot program and subsequent study. The Research Institute for Home Care (RIHC) helped support the research. It really flips the discharge and starts the initiation of care at the hospital, instead of the home,” Schiller told HHCN. “It

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UHF Highlights Methods to Improve SNF-to-Home Transitions

Home Health Care

Transitions of care involving seniors — especially those with multiple chronic conditions — can be risky. Despite this, there are a number of methods skilled nursing facilities (SNFs) and other health organizations can adopt to improve the transition from inpatient care to home for patients and their caregivers.

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What is the Ideal Patient Discharge Experience?

Healthcare Leadership

Patient Perspectives on Care Transitions From Hospital to Home”, JAMA Network Open , 6 May 2022, [link] , accessed 19 March 2023 “Hospital discharge planning hinges on good communication”, Healthy Debate , 6 June 2017, [link] , accessed 19 March 2023 Minemyer, Paige. “The

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Voices: Susan Mills, Senior Program Director for Home Health and Hospice, ACHC

Home Health Care

ACHC initially focused on accrediting home health agencies, but over the years, it has expanded its scope to include other health care sectors such as hospice, hospital, pharmacy, DME, home care and renal dialysis.

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InnovAge Appoints New CEO; Axxess Beefs Up Executive Leadership Team

Home Health Care

PACE is a Medicare and Medicaid program that helps keep people in their communities instead of nursing homes. Oftentimes, programs are run out of community-based centers with the support of in-home care providers and their staff. Axxess adds three executives to its leadership team.

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More than a Feeling: Using Research and Data to Drive Home-and Community-Based Services Improvements 

NASHP

They are consequently significantly overrepresented in institutions, such as nursing facilities. They are also less likely to be employed or have a stable home , adequate medical care , and informal supports in the community. They live shorter lives and develop chronic health conditions earlier in life than other Americans.