Identify that Resource
Partner with these multidisciplinary team members to facilitate discharge education...
Who are the Bedside Nurse and/or Therapist?
SDOH, Age, Comorbidities, Functional Status, Medication Adherence are the examples of ....
What are the patient related factors that contribute to readmission?
Medication reconciliation, Medications education, Pharmacy to educate on medications, Provide referrals to patients for access to medications are....
What are the Medication strategies to prevent readmissions?
You can escalate predicted problems to them for troubleshooting or to assist with barriers...
Who is Leadership?
Quality of Care, Hospital Length of Stay, Access to Post-Discharge Care, Communication Gaps, Discharge Planning, Transition of Care are examples of...
What are the hospital related readmission risk factors?
Clinical Risk assessment tools, Clinical Judgement, Data Analysis are ways to....
How would you identify a patient with high risk for readmission?
Involve this team member to facilitate peer to peer discussions with the attending regarding complex cases ...
Who is your Physician Advisor?
High risk DRGs, Severity of Illness, Specific Disease Complications are examples of ...
What are the disease specific factors for readmission?
Identify patients at high risk for readmission, thorough discharge planning, refer patients to the most appropriate post-acute setting and promote cross-continuum communication are.....
What are the readmission prevention strategies?
The assigned DRG for your patient's case is 313 Chest Pain with a GMLOS of 1.7 days but today is LOS day 3 & you notice that the physician documented "acute myocardial infarction." You reach out to this team to discuss the discrepancy...
Who is CDI?