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Tools and Resources for Arizona

Medical Worker Provider in Home with Senior Patients

You will find downloads for specific tools and resources to assess your organization and assist your partners in managing readmissions.

High-Risk Medications (HRMs)


Anticoagulants: Include These Key Elements for Warfarin Management at Discharge
A single sheet that includes a chart audit tool to see if patients in your care on warfarin have all five elements of warfarin management in their transfer documentation.

Warfarin: Why You Need It: How It's Monitored, Interactions to Recognize
Four pages that includes warfarin pocket cards with indications and interactions; staff member quiz for knowledge regarding warfarin interactions; and warfarin patient education competency validation checklist for staff members.

Anticoagulant Clinics in Maricopa County, Arizona

Anticoagulant Clinics in Pima County, Arizona
Find a list of outpatient anticoagulation clinic. Patient enrollment in an outpatient anticoagulation clinic is an effective strategy for reducing the incidence of complications (blood clot and major bleeding) and improving the quality of anticoagulation control by increasing time in therapeutic range.

Quick Tips for Prescribers—Anticoagulants
This sheet includes tips for reducing ADEs involving anticoagulant medications.

Diabetic Agents

Diabetic Hypoglycemia: Recognizing common Symptoms and Managing a Hypoglycemic Event
Includes staff member education on the symptoms of hypoglycemia and a patient sheet on snacks to ward off a hypoglycemic event

Diabetes Education: Use Teach-Back to Help Patients Successfully Manage Their Insulin
A staff member sheet on how to use teach-back methods to educate patients on insulin basics, injection, storage, and syringe disposal.

Quick Tips for Prescribers—Diabetic Agents
This sheet includes tips for reducing ADEs involving diabetic agents.


Opioids: Strong Warnings Against Combining Opioids for Pain, Cough Medicines, and Benzodiazepines
Provides a simple, single sheet overview of drug guidelines when prescribing opioids with sleeping aids, anti-anxiety medications, and cough medicines.

Opioids: Centers for Disease Control and Prevention (CDC) Prescribing Guidelines for Clinicians
This single sheet offers an overview of CDC tools for opioid prescribing guidance and links to flyers, posters, videos, and the Prescription Drug Monitoring Programs database.

Quick Tips for Prescribers—Opioids
This sheet includes tips for reducing ADEs involving opioids.

Medication SBARs (Situation, Background, Assessment, Recommendation for Action) for High-Risk Medications

Anticoagulants, opioids, and diabetic agents are covered each month in the Medication Management SBARs.

1. Medication SBAR: Taking Medications

2. Medication SBAR: Patient Medication History

3. Medication SBAR: More About Taking a Medication History

4. Medication SBAR: Medication History and Patient Lists of Medications

5. Medication SBAR: Reducing Adverse Drug Events (ADEs)

6. Medication SBAR: Standardizing Medication History

7. Medication SBAR: Verify Internal Processes for Patients on HRMs and at Risk for Readmission

8. Medication SBAR: Reducing Anticoagulant ADEs

9. Medication SBAR: Reducing Diabetic Agent ADEs

Adverse Drug Event (ADE) Tools

Reducing ADEs—What Providers Can Do
This information sheet outlines high-risk medication-related readmissions in Arizona, with tips for providers to reduce the risk of ADEs for their patients.

Reducing ADEs—Best Practices
This information sheet for Arizona outlines the importance of medication safety and hospital readmissions, with stats on high-risk medication readmissions in the state.

ADE Best Practice Reference Tool
Resource references for Medication reconciliation, bedside delivery, pharmacist counseling, post-discharge follow-up, medication therapy management, and medication history.

A Medication History Toolkit  
This 28-page workbook steps, worksheets,and tools to help an organization develop goals and standards for taking patient medication histories.

 Pharmacist Partnerships Improve Medication Management Outcomes  
A video on how pharmacist counseling for patients  can help an organization improve its medication management.

A Medication Safety Program Assessment: Step-by-Step Guidance for Hospitals 
This single-page guide outlines steps to assess your organization's medication safety program.

Medication Management Assessment Organizational Summary 
This worksheet will help you prioritize your organization's areas of improvement.

Medication Management Assessment

The Medication Management Assessment and accompanying Adverse Drug Event (ADE) Gap Analysis components provide evidence-based recommendations and standards for hospitals in the development of a comprehensive medication safety program. The tools reflect published literature and guidelines by relevant professional organizations and regulatory agencies. You can also visit the Medication Assessment page, which  includes the tools below.

  • Medication Management Assessment 
    • This assessment of evidence-based recommendations and standards was originally developed by the Minnesota Hospital Association as part of the CMS Partnership for Patients Initiative and has been adapted by HSAG.

National Resources: Medication Management

Find BPIP, CHAMP, and other medication management tools here.

Organizational Assessment Summary
Use this worksheet to help establish focus areas for your organization.

5 Whys Worksheet
This worksheet will help your organization identify the root cause of your initial problem.

5 Key Areas Overview
Tips on areas known to reduce avoidable readmissions, including discharge planning, medication management, patient/family engagement, transition care support, and transition communications.

7-Day Readmission Checklist
Obtain insight into why a readmission within 7 days has occurred and how it could have been avoided.

Skilled Nursing Facility 7-Day Readmissions Chart Review Tracking Tool
Use this printed chart review tool to discover issues that are driving readmissions from your facility back to the hospital, including transfer information, facility issues, and resident/family issues.

Skilled Nursing Facility 7-Day Readmission Chart Review Tracking Spreadsheet
This Excel spreadsheet helps skilled nursing facilities track and chart issues that are driving readmissions from your facility back to the hospital, including transfer information, facility issues, and resident/family issues. Results can be displayed as bar graphs for easy visual reporting.

Reflective Discussion Questions
This worksheet will help stimulate discussion to identify key areas of opportunity and next steps.

Strategy Tree
This template will help you assess readmission challenges, set goals, develop a strategy, and implement tactics and tasks.

SWOT Analysis Worksheet
Identify your organization's internal and external strengths, weaknesses, opportunities, and threats.

Typical Failures in Discharge Planning
Help identify possible discharge failures in discharge planning, medication management, patient/family engagement, transition care support, and transition communications.

Admission Assessment Observation Tool
Discover the current process to identify patients for observation during admission assessment with this tool.

Discharge Observation Tool
Discover what went well and what did not work as planned and predicted by observing the patient on the last day of acute care hospitalization.

Interviews With Patients, Family Members and Care Teams
Use this tool to conduct interviews with key team members regarding a patient's readmission.

Zone Tools for Patients 
Find handouts to download for asthma, chronic obstructive pulmonary disease (COPD), diabetes, heart disease, kidney health, medications, and much more.

Ask Me 3 (coming soon)
This patient education program is designed to improved communication between patients and healthcare providers, encourage patients to become active members of their healthcare team, and promote improved health outcomes.

Teach-Back Tools
Discover tools and downloadable worksheets for teach-back, including handouts for competency, teach-back observation, coaching, and video resources here.

Teach-Back Starter Sentences

Teach-Back Plain Language

Teach-Back Heart Failure Starter Sentences

Teach-Back Heart Failure Plain Language

Health Literacy Toolkit
Scientific studies have shown the correlation between patients’ health literacy level and health outcomes. This toolkit provides resources for assessment, communication, patient education, community support, and medication management.

Community and Behavioral Health
Find local, state, and national behavioral health resources here.

Find national resources for inpatient psychiatric facilities here.

National Resources
Find links to national resources, including tools and articles, for care coordination to assist hospitals, nursing homes, home health agencies, hospices, and physicians in reducing 30-day avoidable readmissions.