, Director, Continuum of Care Services

This session will explore a collaborative effort between hospital and hospitalist group to develop and implement a solution to reduce readmissions. This solution is customized to fit the organization’s patient population needs, as well as available hospital and community resources. The presentation will outline: the formation of a multi-disciplinary readmission team, the approach, on-site resource assessment and gap analysis, and development and implementation of customized tools and workflows.

 

Learning Objectives:
1. Create a population specific solution to reduce unnecessary readmissions

2. Implement a team-developed, multi-agency, interdisciplinary, effective set of interventions

3. Develop a team with healthy, strong working relationships