Each week there is something new about how we can improve patient care by improving transitions for patients between healthcare units. A recent Medicare initiative aimed at smoothing transitions of care through community-based interventions successfully lowered 30-day readmission rates and all-cause hospitalization rates among beneficiaries, according to a study. Medicare quality improvement organizations (QIOs) in a 14-community project relied on patient coaches, medication-management strategies, home health tool kits, enhanced discharge planning and other interventions to keep patients out of the hospital. Communities that had these multistakeholder care-transition programs in place had lower rates of 30-day all-cause readmissions and all-cause hospitalizations than did comparison communities with no such interventions, according to the study, which appeared in the Journal of the American Medical Association.
This concept goes a long way to meeting the healthcare reform law’s Community-Based Care Transitions Program and HHS Partnership for Patients, a federal initiative whose goals include a 20% drop in readmissions by the end of 2013.
Part of this care transition includes patient education and especially in seniors it seems that group education works best (See this week’s Item #3). This study published in Diabetes Care points to the value of patients interacting and sharing their problems and solutions. This might be yet another good reason to consider a Shared Medical Appointment for your senior diabetes patients.
With a day packed full of education, motivational tools, one-on-one sessions, and workshops, the TCOYD health fair is a great way to get your patients to take better care of their health and themselves. TCOYD.com
Topics: Ben Gray shares a day in his diabetes life; from the dLife kitchen, a warm soup perfect for cold days — winter squash soup; Jim Turner teaches us the language of diabetes; and dLife visits an animal clinic to learn more about pets with diabetes. Sundays live online at dLifeTV.com at 7 PM ET, 6 PM CT, and 4 PM PT. Keep up on the latest dLife news at dLifeTV.com.
Please answer this week’s poll: Would you like to learn about Shared Medical Appointments or Patient-Centered Medical Homes?
We can make a difference!
Dave Joffe, Editor-in-chief