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Understanding Transitional Care Management in Reducing Readmissions

Guideway Care

Key Takeaways Transitional Care Management (TCM) improves care coordination and significantly reduces hospital readmissions through a structured approach that encompasses patient follow-up and communication. Initiatives such as Project RED and BOOST augment care transitions by conducting follow-up calls with patients.

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Care Coordination: The Key to Improving Patient Outcomes

Relias

By incorporating care coordination practices such as risk assessment, care planning, care transitions, patient education, patient navigation, telehealth, and home visits, care coordination teams can bring in resources to help patients navigate health concerns that span physical, behavioral, and social risk factors and needs.

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Enhancing Patient Safety in Nursing: Strategies and Practices

Relias

They monitor patients’ conditions, administer medication, and convey self-care and discharge information. Because nurses are directly involved with patients on a day-to-day — and often hourly — basis, improving their ability to provide high-quality care is critical to a successful patient safety strategy.

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Why Care Coordination Is Important for Home Health and Hospice Agencies

Relias

Comprehensive education for home health staff is vital to boost performance under HHVBP, observed Relias Director of Post-Acute Care Solutions Trish Richardson, MSN, BSBA, RN, NE-BC, CMSRN. Hospices should also be concerned about care coordination. As part of discharge planning. Increased scrutiny in hospices.

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New HIPAA Regulations in 2022-2023

The HIPAA Journal

The Centers for Medicare and Medicaid Services (CMS) also published an interoperability rule in March 2020 that applies to Medicare- and Medicaid-participating short-term acute care hospitals, long-term care hospitals, rehabilitation hospitals, psychiatric hospitals, children’s hospitals, cancer hospitals, and critical access hospitals (CAHs).

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