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  1. www.ahrq.gov/patient-safety/settings/hospital/resource/guide/web5.html
    December 01, 2017 - Webinar 5: Reach Out to Collaborate with Partners Across Settings: Slide Presentation Designing & Delivering Whole-Person Transitional Care: The Hospital Guide to Reducing Medicaid Readmissions Text version of Webinar slide presentation. Slide 1: Designing & Delivering Whole-Person Transitional Care Des…
  2. www.ahrq.gov/patient-safety/settings/hospital/resource/guide/tools.html
    October 01, 2016 - Designing and Delivering Whole-Person Transitional Care Tool Overview This package of tools accompanies the Designing and Delivering Whole-Person Transitional Care: The Hospital Guide to Reducing Medicaid Readmissions , which offers indepth information about the unique factors driving Medicaid re…
  3. www.ahrq.gov/teamstepps-program/curriculum/implement/pre.html
    December 01, 2023 - Present Slide 6, "Implementing TeamSTEPPS: Pre-Implementation Activities"; use this slide to make the transition
  4. www.ahrq.gov/sites/default/files/wysiwyg/sops/surveys/2024-sops-deidentified-research-datasets.pdf
    January 01, 2024 - pharmacy/index.html https://www.ahrq.gov/sites/default/files/wysiwyg/sops/surveys/hospital/hsops2-pt1-transition-updated.pdf
  5. www.ahrq.gov/sites/default/files/wysiwyg/coronavirus/long-covid-care-network/uc-sf-grantee-profile.pdf
    January 01, 2024 - experiencing homelessness and communities such as Latinx, Black, and Asian individuals, by facilitating their transition
  6. www.ahrq.gov/sites/default/files/publications/files/caremgmt-brief.pdf
    April 01, 2015 - Becoming a patient-centered medical home: a 9-year transition for a network of federally qualified health
  7. www.ahrq.gov/ncepcr/care/coordination/mgmt.html
    August 01, 2018 - Becoming a patient-centered medical home: a 9-year transition for a network of federally qualified health
  8. www.ahrq.gov/cpi/about/brief-history.html
    March 01, 2025 - and patient safety advocate, was named director of AHCPR in 1997 and guided the agency through its transition
  9. www.ahrq.gov/practiceimprovement/delivery-initiative/dowdstudysnapshot.html
    November 01, 2015 - While bonuses may be necessary early on to gain acceptance of a voluntary reporting program, a timely transition
  10. www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol1/Advances-Henriksen_104.pdf
    January 01, 2025 - courageous, passionate, innovative, and willing to offer tools and training to providers and staff to transition
  11. www.ahrq.gov/patient-safety/resources/continuing-ed/moc-ha.html
    October 01, 2020 - In an effort to assist clinicians (Physicians for MOC Part IV credit and CME QI for PAs) transition from
  12. www.ahrq.gov/pqmp/implementation-qi/toolkit/h2h/key-driver.html
    July 01, 2021 - Quality of Pediatric Hospital-to-Home Transitions Toolkit Key Driver Diagram Previous Page Next Page Table of Contents Quality of Pediatric Hospital-to-Home Transitions Toolkit Introduction Overview About the Measure Key Driver Diagram Quality Improvement Strategies Improvement Data Ot…
  13. www.ahrq.gov/ncepcr/reports/2024-annual-report/appendix-c.html
    May 01, 2024 - pharmacist-provided comprehensive medication management to coordinate care for high-need/high-cost patients when they transition … anticoagulants (DOAC) Checklist for Optimal Care Transitions to elaborate the steps required to ensure a safe transition … This project operationalizes the items of the Checklist to create a comprehensive care transition intervention … The care transition intervention will have the potential to prevent DOAC-related medication errors, improve
  14. www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/engagingfamilies/strategy4/Strat4_Implement_Hndbook_508_v2.pdf
    April 01, 2011 - Engaging patients and families in the discharge planning process helps make this transition in care … The goal of the IDEAL Discharge Planning strategy is to engage patients and family members in the transition … Foundation and the Institute for Healthcare Improvement, developed the How-to Guide: Creating an Ideal Transition … discharge • Coordinate home-based care and special equipment needs • Prepare the patient and family for transition
  15. www.ahrq.gov/ncepcr/care/coordination/atlas/chapter4.html
    June 01, 2014 - evaluating coordination as older adults who have experienced certain fractures (hip, spine or distal radius) transition … sum of transitions listed above exceeds the total number of measures that evaluate any cross-setting transition
  16. www.ahrq.gov/sites/default/files/2024-01/france-report.pdf
    January 01, 2024 - The presence or absence of each type of perioperative provider was recorded for each observed care transition … The SOS was been reworded to ask about ‘the care you provided for this baby during this care transition … The SOS was administered to Care Transition Teams no later than 1-hour after their handover (slightly … For Aim 1a, the median team SOS score (for stratified analysis of NICU transition and OR teams) or median … i.e., from past research studies), partitioned by perioperative phase (i.e., preoperative care, care transition
  17. www.ahrq.gov/patient-safety/settings/hospital/resource/guide/web2.html
    December 01, 2017 - Webinar 2: Analyze Data and Patient/Caregiver Perspectives (Section 1 of the Guide): Slide Presentation Designing & Delivering Whole-Person Transitional Care: The Hospital Guide to Reducing Medicaid Readmissions Text version of Webinar slide presentation. Slide 1: Designing & Delivering Whole-Person Transit…
  18. www.ahrq.gov/ncepcr/care/coordination/atlas/chapter6w.html
    June 01, 2014 - care – general, (2) patient/family-centered care, (3) chronic care, (4) coordination of care, and (5) transition
  19. www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/medicaidreadmitguide/aspire_webinar5/aspire_webinar5.pptx
    June 02, 2025 - Designing & Delivering Whole-Person Transitional Care The Hospital Guide to Reducing Medicaid Readmissions Webinar 5 Designing & Delivering Whole-Person Transitional Care The Hospital Guide to Reducing Medicaid Readmissions Webinar 5:Reach Out to Collaborate with Partners Across Settings Agenda Describe the impo…
  20. www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/nicu_toolkit/nicupacket-apc.pdf
    June 02, 2025 - Transitioning Newborns from NICU to Home: Family Information Packet, Appendix C Appendix C: NICU Needs Assessment Infant’s Name: Date of Birth: ID#: Male Female Bed#: Caregiver’s Contact #: Address: Pediatrician Name and Number: Birthweight Current Weight Primary Diagnosis Newborn Blood Screening Date: _______…

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