In regards to increasing federal and public scrutiny to cost effective treatment and improve quality of care under HRRP statute, I recommend the implementation of the project CAFÉ (Communication, Adherence, Follow-up and Education). It focuses on enhancing the clarity and effectiveness of treatment adherence and discharge plan with coordinated care, and avoiding penalties under the statute. The project includes interventions and criteria to measure effectiveness at each level of care. It will help to identify populations with higher readmission rates for targeted interventions. Tracking changes from gathered information will allow Central Health to utilize resources more thoughtfully. The purpose of this initiative is to …show more content…
However, I understand that many readmissions are unavoidable due to the natural course of disease, patient’s preference and treatment guidelines, this project would certainly prepare Central Health to take the lead to provide coordinated care for …show more content…
Ensure that patients have correct prescribed medication list with number of doses and timing. Assure that patients have the means to adhere to the treatment and follow-up appointments (e.g. financial, transportation, preventive care). Contact patients who missed an appointment and address any barriers they may have for treatment adherence.
3) Follow up with patients. Follow up call within 10 days of discharge from patient care coordinator to ensure treatment adherence. Prioritize frequency of calls for all patients with specific conditions (e.g. Diabetes, COPD, stroke). Use telemedicine service for vital information exchange with clinician to determine the care planning.
3) Patient education. Help patients to understand common mistakes with medication to reduce their fear and uncertainty with warning signs and medication error. Provide early warning signs and symptoms of adverse events of medication, or worsening of condition. By educating patients to manage acute events and minor chronic conditions, and precautions to take in future, Central health can prevent readmission.
The First five years of the Hospital Readmission Reduction Program summary, penalty formula, and payment adjustment are attached for your