Reducing Care Fragmentation

Reducing care Fragmentation A TOOLKIT. FOR COORDINATING care . Reducing care Fragmentation 1. Contents I. Introduction 1. MS. G: A Case Study in Fragmented II. The care Coordination Model 4. care Coordination MS. H: A Case Study in Coordinated III. Change Package and Tools 8. Key Change / Activities #1 KEY CHANGE: Decide as a primary care clinic to improve care #2 KEY CHANGE: Develop a referral/transition tracking Patient #3 KEY CHANGE: Organize the practice team to support patients and families during referrals and Relationships and #4 KEY CHANGE: Identify, develop and maintain relationships with key specialist groups, hospitals and community #5 KEY CHANGE: Develop agreements with these key groups and #6 KEY CHANGE: Develop and implement an information transfer IV. Case Studies 18. FAMILY care NETWORK: Developing Agreements between Primary care and Specialty GENESYS health SYSTEM: Developing Linkages with Community HUMBOLDT COUNTY: Tracking Referrals through an Electronic Referral SAN FRANCISCO GENERAL HOSPITAL: Connectivity through Electronic OKLAHOMA SCHOOL OF COMMUNITY MEDICINE: Developing and Implementing an Electronic Consultation V.

Reducing Care Fragmentation: A Toolkit for Coordinating Care, is supported by The Commonwealth Fund, a national, private foundation based in New York City that supports independent research on health care issues and makes grants to improve health care practice and policy. The view presented here are those of the authors, and not

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  Health, Care, Reducing, Health care, Fragmentation, Reducing care fragmentation

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