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Home Health Agency

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Care Coordination

BOOST - Better Outcomes by Optimizing Safe Transitions

A National initiative led by the Society of Hospital Medicine to improve the care of patients as they transition from hospital to home.



Enhance Home Health Care Delivery Model

The Enhanced Home Health (EHH) care delivery model provides a minimum of seven touch points to the patient within two weeks of a hospital discharge.



Medicare Initiatives

Home Health Cardiovascular Health Improvement Initiative

In partnership with the Home Health Quality Improvement (HHQI) National Campaign and many statewide home health agency professional membership organizations, Health Services Advisory Group is encouraging home health agencies to join the Cardiovascular Health Improvement Initiative and participate in the Home Health Cardiovascular Data Registry. Details of the programs are included in the following links:



Home Health Quality Improvement

A national campaign dedicated to improving the quality of care provided to America’s home health patients.



Organizations

Alliance for Home Health Quality and Innovation

AHHQI works to strengthen home health care as a cornerstone of the nation's healthcare system.



Reports and Articles

Joint Commission Transitions of Care

A Report from the Joint Commission on transitions of care and the need for collaboration across the entire care continuum.



Telephone Support

Post-discharge telephonic support has evidenced a reduction in hospital readmission rates. The sooner this type of support is provided to the patient post-discharge, the greater the reduction in readmissions



Tools and Guides

Advance Care Planning

Advance care planning can assist with readmissions by understanding the patient’s care preferences. Home health agencies can initiative these conversations and better understand their patients’ wishes for end-of-life treatment.



CHAMP

The CHAMP Program was the first national initiative to advance home care excellence for older people. Find selected and organized evidenced-based tools to create an online geriatric care transitions toolkit.