Preston Memorial lowered heart failure readmissions to zero by implementing a fitted shoe program.

By standardizing verbal and written transitions processes, UW ensures accurate clinical information is exchanged.

The University of Wisconsin Hospitals and Clinics created a SNF-Acute Care coalition to address challenges of transitioning between settings.

Scott & White Memorial Hospital & Medical Center improved medical management in SNFs to reduce hospital readmissions.

To improve care transitions for individuals with cognitive impairments, Dominican Hospital developed a support care handoff tool.

Duke Children's Complex Care Service aims to coordinate longitudinal care across the continuum for children with medical complexity.

Hallmark Health System, Mystic Valley Elder Services, Somerville-Cambridge Elder Services and Cambridge Health Alliance developed a program to enhance existing discharge practices and patient care at multiple service locations.

One integral component of reducing our readmission rate from 9 percent to 5 percent was conducting 72-hour callbacks.

We are a Critical Access Hospital that began with a 9 percent readmissions rate in 2011. Through team collaboration we have been able to decrease our readmissions rate.

We reduced our readmission rate from 9 percent to 5 percent in a very short period of time. We are happy to share our tips while continuing to learn and improve!