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Reducing re-admissions

Reduce re-admissions by speeding up the process of receiving clinical services after hospital discharge. Implement open time slots for evaluations and create emergency post-hospital evaluations to ensure prompt care. Ongoing data collection and monitoring to track progress.

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Reducing re-admissions

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  1. Reducing re-admissions St. croix county, wi

  2. Reduce the time is takes to receive clinical services from the point of hospital discharge to initial evaluation with provider. AIM Reduce the number of providers a client is required to meet with prior to being set with their on-going provider. (Example: Versus doing phone interview, coming in for orientation, meeting for a full evaluation, then being set with a therapist we would require the one step into whichever provider best suits needs.)

  3. Create emergency post-hospital evaluations for clients discharging from inpatient. • Mental Health Therapist provided 2 open slots per week for clients discharging from inpatient. • CCS and CSP Provider each provided 1 open slot per week for clients discharging from inpatient. • Crisis Social Worker to determine which slot the client would fill depending on their level of need. CHANGE

  4. RESULTS • Change process is still active as data collection is not complete. • Average waiting time from initial phone screen to evaluation w/ provider from Jan. 2018-Sept.2018 was 14.2 days. – We’ve now created open time slots to ensure clients are seen within the same week of hospital discharge. • We’ve had one client accept an Emergency Post-Hospital Evaluation that was able to be scheduled 2 days post hospital discharge; this client rescheduled herself twice prior to making the appointment and has now rescheduled her next appointment twice as well.

  5. NEXT STEPS • Continue to monitor the Change Plan.

  6. IMPACT • Lessons learned = To Be Determined as we continue to collect data and monitor discharges.

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