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NHA Quality Care Transitions virtual learning cohort

Wednesday, January 25, 2023
12:00 pm1:00 pm

NHA Quality Care Transitions
Transitions of Care Management, Chronic Care Management, Readmissions, High-Utilization
Virtual Learning Cohort
Learning Sessions and Rapid Cycle Improvement Project

Program Overview
This 6-part learning cohort will be led by a multidisciplinary team from various hospitals and organizations across Nebraska. The cohort will support hospitals to create, implement or augment processes aimed at preventing readmissions and decreasing unnecessary high utilization of healthcare by developing a Chronic Care Management and/or Transitional Care Management program. This work will help hospitals decrease patient harm and drive efficient use of healthcare. By using a rapid cycle improvement methodology, teams will move through a PI process in a short timeframe. Hospitals will work with a multidisciplinary team during multiple interactive workshops to form an Aim Statement, implement small tests of change, adopt new processes, and create a sustainability plan.

Target Audience
Multidisciplinary Team, Quality Leaders/Staff, Nursing Leaders/Staff, Clinic Staff, Discharge Planners, Care Coordinators, Providers

Cost
No cost is associated with this program for member hospitals
Register
Click here to register - https://online.nebraskahospitals.org/events/event-registration/?id=087e440a-3091-ed11-a76e-0003ff66c187

Session #1 – Care Coordination in a Critical Access Hospital
Interactive Session- Participation Encouraged

January 19, 2023, 12:00 - 1:00 PM CT

Objectives:
Success Metrics and Why it is Important
Understanding the Variety of Care Models
Return on Investment
Age-Friendly Care Planning and Quality Metrics
Complete a Pre-Gap Analysis
Create an Aim Statement

Speakers: Dana Steiner and Amber Kavan, Nebraska Hospital Association

Session #2 – Chronic Care Management
January 25, 2023, 12:00 - 1:00 PM CT

Objectives:
Setting up a Chronic Care Management Program
Building Efficiencies for Success
Improving Quality Outcomes for Patients with Chronic Diseases
Documentation Requirements, Billing, and Coding for CCM

Speakers: Howard County Team

Session #3 – How Care Transitions Impact Patient Safety
February 15, 2023, 12:00 - 1:00 PM CT

Objectives:
Describe the Importance of Communication and Documentation in the Transitions of Care Process
Evaluate Strategies to Medication Reconciliation and Communication of Further Treatment to Ensure the Patient’s
Understanding at a Transition of Care
Analyze Existing Workflows for Potential Gaps in Communicating Test Results and Needed Follow-up for Patients

Speakers: Emily Barr and Carla Snyder, Nebraska Coalition for Patient Safety (NCPS)

Session #4 – Preventing ED and Hospitalization Overuse
February 28, 2023, 12:00 - 1:00 PM CT

Objectives:
Identifying Multi-Visit Patients
Successful Discharge Planning Using a Multi-Disciplinary Approach
Understanding Community Resources
Implementing Patient Discharge Follow-Up Phone Calls for Improvement
Driving and Improving Patient Satisfaction Scores

Speakers: Jenna Watson, Memorial Hospital, Aurora

Session #5 – Transitional Care Management
March 14, 2023, 12:00 - 1:00 PM CT

Objectives:
Implementing a Transitional Care Management Program
Building Efficiencies for Success
Improving Quality Outcomes for Patients who are Hospitalized
Documentation Requirements, Billing, and Coding for TCM
Other Billable Care Coordination Codes

Speakers: Jenna Watson, Memorial Hospital, Aurora and Sherry Radford, Bryan Health

Session #6 – Bringing it all Together/Creating a Sustainability Plan
Interactive Session- Participation Encouraged
March 30, 2023, 12:00 - 1:00 PM CT

Objectives:
Review of learning cohort
Quality improvement efforts to reduce patient harm
Augment or Implement Age-Friendly into your System
Identifying and navigating barriers/successes during process improvement
Complete Post-Gap Analysis
Roundtable discussion on improvement efforts

Speakers: Dana Steiner and Amber Kavan, Nebraska Hospital Association

Contacts
For more information, please contact Dana Steiner – dsteiner@nebraskahospitals.org or Amber Kavan – akavan@nebraskahospitals.org