Post Non-VA Hospitalization Care Transition Management: One Call System

Problem: The Viera VA Clinic PACT has an established goal of contacting their Non-VA hospital discharges within seven days of discharge. This measure is met 64% of the time.

Measurement: Manual abstraction and analysis HAS daily ROI of hospital records: 100% compliance by VIERA VA HAS, identified issues with receipt of records from Non-VA hospitals via fax. PACT RNCM follow up call to Veteran within seven days of discharge: 64% compliance by the VIERA VA RNCM.

Analysis: GEMBA, process mapping, cause analysis and pick charts.

Implementation: Implementation of 1). right fax, 2). the one call system, and 3). granted access to electronic Non-VA records to VA CHNs/UMs. PDSA cycles allowed for small test of change and monthly team calls created close loop communication.

Results/Discussion: Right Fax and Access to Electronic Non VA records increased efficiency in PACT, Scanning and CHN/UM. PACT RNCM post discharge follow up increased to 98% compliance for all Health First TCM Discharges (reduced readmit rate to 12%) and to 75% for all Non VA discharge in the County.

Speakers
Quality Management
Quality Management - VHA

Speaker Type: Poster Presentations On-Demand

  • Patient Safety IconPatient Safety

Speaker Type: Poster Presentations On-Demand

  • Patient Safety IconPatient Safety
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