Medical Center Health System designed and implemented a community health department to build a healthier community.

Baptist Memorial Hospital focused on reducing pneumonia readmissions through Kata, a rapid cycle improvement process

Riverview Health evaluated its processes and implemented strategies to ensure compliance with Indiana’s CARE Act.

Reducing heart failure readmissions required an organized, comprehensive approach at Mary Washington Hospital.

Sakakawea Medical Center and Coal Country Community Health Center worked to improve their continuous care model to ensure patients consistently received warm hand-offs.

Illinois Valley Community Hospital implemented a program combining elements of the Coleman and Naylor models.

Saline Memorial Hospital focused on improving communication, education and daily reporting to reduce readmissions.

Aledade Delaware ACO developed a population health management tool to more effectively coordinate care.

Alliant Quality leverages community partnerships to engage patients in diabetes self-management.

Care coordination helps lower the incidence of anticoagulant-related adverse events among Centura Health Medicare patients.

Greenbriar Community Care Center’s re-hospitalization numbers decreased following data-driven interventions.

The Cancer Center at Presbyterian Hospital initiated quality-of-life care planning to improve the patient care transition experience.

The development of a comprehensive chronic disease management program can significantly improve a patient’s quality of life.

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.

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.

Duke has taken a broad approach to opioid safety. This has included developing guidelines and tools. The next step involves reaching out to our clinicians.

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!