5 Care Transitions Programs Win Robert Wood Johnson Foundation Challenge

The Robert Wood Johnson Foundation announced five winners of a challenge to reduce potentially avoidable hospitalizations through better care transitions.

RWJF's "Transitions to Better Care" video contest, part of its "Care About Your Care" initiative, called for submissions of videos demonstrating innovative, patient-centered approaches to transitioning patients safely and effectively between care settings. Here are the five winners chosen from among more than 100 entries:



•    Cullman (Ala.) Regional Medical Center. Cullman Regional Medical Center implemented a program called "Good to Go," in which caregivers record discharge sessions so patients can listen and ask questions to clarify information.
•    Mercy Health (Cincinnati). Mercy Health implemented a team-based system of evaluating and treating patients and preventing readmissions.
•    Northern Piedmont Community Care (Durham, N.C.). Northern Piedmont Community Care created a community-based care management system that provides transitional care, chronic disease management, social work services, service coordination, access support, health education and nutrition counseling.
•    Queen of the Valley Medical Center (Napa, Calif.). Queen of the Valley Medical Center developed a CARE Network to provide case management, advocacy, resources/referrals and education.
•    University of Utah Health Care (Salt Lake City). University of Utah Health Care implemented the Health Care Transitions Program that included a transition navigator to follow-up on complex patients discharged from the hospital.

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