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21. Information to Help Hospitals Get Started
    www.cpsi.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/engagingfamilies/howtogetstarted/How_to_Use_Guide_Ldr_Slide_508.pptx
    July 23, 2010 - Involving patients and families in discharge planning and plans for safe care at home. … Nurs Adm Q 2006;30(2):112–22.  14 Why focus on discharge planning? … A review of discharge planning research of older adults 1990-2008. … Hospital discharge planning for frail older people and their family. … Discharge planning from hospital to home. Cochrane Database Syst Rev 2010;20(1):CD000313.

22. AHRQ's RED Toolkit Helps Lower Readmissions in Dignity Health Hospitals | Agency for Healthcare Research and Quality
    www.cpsi.ahrq.gov/news/newsroom/case-studies/201522.html
    August 01, 2015 - planning at the 426-bed Bakersfield Memorial Hospital. … planning and care transitions process," Mr. … developed by AHRQ-funded researchers, provides evidence-based tools to help hospitals re-engineer their patient … discharge processes. … RED interventions focus on comprehensive discharge planning, patient education, and post-discharge patient

23. Information to Help Hospitals Get Started (pdf file)
    www.cpsi.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/engagingfamilies/howtogetstarted/How_to_Use_Guide_Ldr_Slide_508.pdf
    May 14, 2013 - Working with Patients and Families at the Bedside: Care Transitions from Hospital to Home: IDEAL Discharge … Planning 11 Information to Help Hospitals Get Started Why work with patients and families as … planning? … planning – Changes in medicines before and after discharge – Inadequate preparation for patients and … Why focus on discharge planning? Moving forward What do we need from you?

24. Consensus Organizational Health Literacy Quality Improvement Measures | Agency for Healthcare Research and Quality
    www.cpsi.ahrq.gov/health-literacy/improve/organizational.html
    September 01, 2020 - Planning Checklist for Scheduled Admissions Prior to admission, hospital staff provide and discuss a discharge-planning … family (e.g., a planning checklist that is similar to the Centers for Medicare & Medicaid Services' Discharge … Planning Checklist) Shift Change Huddles/Bedside Reporting Hospital conducts shift change

25. Transitioning Newborns from NICU to Home: A Resource Toolkit (pdf file)
    www.cpsi.ahrq.gov/sites/default/files/wysiwyg/patient-safety/settings/hospitals/nicutoolkit.pdf
    January 01, 2004 - During the discharge planning and transition process, a Health Coach can help prepare the family to … – New patients – while discharge planning should always “begin at admission,” any infant whose expected … ■ Discharge planning (insurance coverage, pediatrician contact information and appointment date,

26. Coaching in the Hospital | Agency for Healthcare Research and Quality
    www.cpsi.ahrq.gov/patient-safety/settings/hospital/resource/nicu/coaching.html
    December 01, 2013 - Prioritize patient visits for the day: New patients—while discharge planning should always "begin at … Discharge planning (insurance coverage, pediatrician contact information and appointment date, CPR education

27. Tool Overview | Agency for Healthcare Research and Quality
    www.cpsi.ahrq.gov/patient-safety/settings/hospital/resource/guide/tools.html
    October 01, 2016 - Incorporate into regular discharge planning assessment and referrals. 4 Tool 10 Discharge Process

28. PS Grantee Report | Agency for Healthcare Research and Quality
    www.cpsi.ahrq.gov/research/findings/final-reports/index.html
    June 01, 2023 - Adults (10) Health Information Technology (9) Nursing Homes (8) Risk Assessment (8) Discharge … Planning (7) Patient Safety Measure Development and Implementation (7) Education and Training … Grant Number: R01 HS 25702 Topic(s): Discharge Planning, Nursing Homes Publication Date: August 2022 … Grant Number: R03 HS 027231-A1 Topic(s): Discharge Planning, Human Factors Approaches To Improve Patient

29. Tool 3: Hospital Inventory (doc file)
    www.cpsi.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/medicaidreadmitguide/mcaidread_tool3_hosp_inv.docx
    September 02, 2016 - clinical readmission risk · Identify the “learner” or care plan partner to include in education and discharge … planning · Use clinical pharmacists to enhance medication optimization, education, reconciliation

30. Designing & Delivering Whole-Person Transitional Care The Hospital Guide to Reducing Medicaid Readmissions Webinar 1 (ppt file)
    www.cpsi.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/medicaidreadmitguide/aspire_webinar1/aspire_webinar1.ppt
    January 01, 2011 - from CMS Reducing readmissions pays – or at least inaction hurts Hospitals must improve standard “discharge … planning” processes Reducing readmissions is a cross-continuum effort Attend to non-clinical needs

31. Designing & Delivering Whole-Person Transitional Care The Hospital Guide to Reducing Medicaid Readmission Webinar 2
    www.cpsi.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/medicaidreadmitguide/aspire_webinar2/aspire_webinar2.pptx
    January 01, 2015 - Designing & Delivering Whole-Person Transitional Care The Hospital Guide to Reducing Medicaid Readmission Webinar 2 Designing & Delivering Whole-Person Transitional Care The Hospital Guide to Reducing Medicaid Readmissions Webinar 2: Analyze Data and Patient/Caregiver Perspectives (Section 1 of the Guide) Agenda …

32. Chapter 6. Measure Maps and Profiles (continued, 14) | Agency for Healthcare Research and Quality
    www.cpsi.ahrq.gov/ncepcr/care/coordination/atlas/chapter6m.html
    June 01, 2014 - Survey — Patient Version Purpose: To gather information on the quality of process and outcomes of discharge … planning activities undertaken in the acute hospital setting from the patient perspective. … planning staff, a health economist, and a qualitative researcher to further test for face and content … The development, validity and application of a new instrument to assess the quality of discharge planning … Discharge planning quality from the carer perspective. Qual Life Res 2000;9:1005-13.

33. Designing & Delivering Whole-Person Transitional Care The Hospital Guide to Reducing Medicaid Readmissions Webinar 3
    www.cpsi.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/medicaidreadmitguide/aspire_webinar3/aspire_webinar3.pptx
    December 01, 2014 - Managed Care Organizations (MCOs) MCOs can assist with: Identify PCP Home Nursing Medication adherence Discharge … planning from all levels of care Disease Management Complex Case Management Coordination of services

34. Information to Help Hospitals Get Started (pdf file)
    www.cpsi.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/engagingfamilies/howtogetstarted/About_the_Guide_508.pdf
    May 13, 2013 - by involving the patient and family in the change of shift report for nurses • Strategy 4: IDEAL Discharge … Planning helps reduce preventable readmissions by engaging patients and family members in the transition

35. Patient and Family Engagement in the Surgical Environment Module: Facilitator Notes | Agency for Healthcare Research and Quality
    www.cpsi.ahrq.gov/hai/tools/ambulatory-surgery/sections/implementation/training-tools/pf-engagement-fac-notes.html
    May 01, 2017 - Using the IDEAL discharge planning method will help prevent postdischarge complications and avoidable … The 5 steps of IDEAL discharge planning are — Include the patient and family (as the patient wishes … IDEAL Discharge Planning Explores the components of a discharge plan and provides guidance on involving … Care Transitions from Hospital to Home: IDEAL Discharge Planning Training . … Strategy 4: IDEAL Discharge Planning (Tool 4) Agency for Healthcare Research and Quality.

36. A Resource Toolkit | Agency for Healthcare Research and Quality
    www.cpsi.ahrq.gov/patient-safety/settings/hospital/resource/nicu/toolkit.html
    December 01, 2013 - During the discharge planning and transition process, a Health Coach can help prepare the family to meet

37. Selected Best Practices and Suggestions for Improvement (pdf file)
    www.cpsi.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d4n_combo_iqi-mortalityreview-bestpractices.pdf
    May 20, 2016 - Selected Best Practices and Suggestions for Improvement Toolkit for Using the AHRQ Quality Indicators How To Improve Hospital Quality and Safety 1 Tool D.4n Selected Best Practices and Suggestions for Improvement IQI: Mortality Review of Select Procedures and Conditions Why Focus on Mortality Review? …

38. Information to Help Hospitals Get Started (doc file)
    www.cpsi.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/engagingfamilies/howtogetstarted/About_the_Guide_508.docx
    May 13, 2013 - nurses by involving the patient and family in the change of shift report for nurses Strategy 4: IDEAL Discharge … Planning helps reduce preventable readmissions by engaging patients and family members in the transition

39. Information to Help Hospitals Get Started (pdf file)
    www.cpsi.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/engagingfamilies/howtogetstarted/Ways_To_Learn_More_508.pdf
    October 28, 2009 - Available at: http://www.caretransitions.org/ Your Discharge Planning Checklist This checklist from … of your Healthcare: Your Path to Being an Empowered Patient The Care Transitions Intervention Your Discharge … Planning Checklist Other resources for improving patient- and family-centered care practices Medication

40. Webinar 1: Introduction & Overview: Slide Presentation | Agency for Healthcare Research and Quality
    www.cpsi.ahrq.gov/patient-safety/settings/hospital/resource/guide/web1.html
    December 01, 2017 - Hospitals must improve standard "discharge planning" processes.