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Fact Based List:
Becker's Hospital Review: 10 Key Components Of A Post-Discharge Care Model
Submitted By Anonymous, Created 07/02/2015 - 12:51
- Assure that there is close and trusted interaction between the outpatient care team and the hospital discharge planners
- Begin the patient-interaction portion of the program with a post-discharge in-home assessment
- Meet with the primary care physician
- Conduct weekly interdisciplinary team conferences
- Provide specialized care and considerations for common geriatric conditions
- Consider the unique physical and psychosocial needs of low-income seniors including dual eligibles
- Focus not only on treating a person's medical condition but for managing a broad array of care needs across multiple settings
- Ensure that your program includes a focus on patient education
- Have the information technology infrastructure in place
- Continue to monitor the patient's progress
Source: Becker's Hospital Review
Source URL: http://www.beckershospitalreview.com/quality/10-key-componen...