3. Help Care Teams Manage [Target] Better in Individual Patient Interactions

Other change package pages: [Target] Change Package Home; Put Key Foundations in Place for [Target]; Manage [Target] Better Hospital-wide; Case Studies

Below are opportunities for improving [Target] related to individual patient interactions, and tools that can help care teams leverage these opportunities. For guidance and tools to strengthen foundational capabilities (e.g., around evidence-supported [Target] management) see the Foundations page. For guidance and resources on hospital-wide approaches to [Target], see the Hospital-wide page. For examples of how hospitals have systematically improved [Target], see the Case Studies page.

For worksheets to help document and analyze hospital workflows for improvement targets [Target], see the Office of the National Coordinator for Health Information Technology (ONC) Resources for Improving Care with CDS. These worksheets and related tools and can help hospital QI teams incorporate tools such as those outlined below into these workflows.

Consider Pre-hospital and Community-based Opportunities

• Review literature and brainstorm with stakeholders to identify pre-hospital opportunities to improve [Target]
  • [Tools]

Support Pertinent Activities Early in Hospital Encounter (e.g., Emergency Department and Registration)

• Address key data needs and patient messaging early to support [Target] during hospital stay
  • [Tools]

Use Opportunities During Main Hospital Stay (e.g., daily rounds, nursing/ancillary interactions, care planning/ordering/execution)

• Use proven risk stratification approaches as appropriate to identify patients especially appropriate for [Target
  • [Tools]
• Design workflows and use tools (e.g., standing orders, documentation templates) to ensure that indicated orders, actions, documentation, etc. occurs during the hospital stay
  • [Tools]
• Provide patient education/engagement materials to ensure that patients and their families are well engaged in [Target]
  • [Tools]

Enhance Discharge-related Activities and Follow-up After Discharge (as appropriate)

• Make sure patients have/understand a self-management plan, hospital summary, and follow-up guidance as appropriate
  • [Tools]
• Follow-up directly with patient and their providers as appropriate, e.g., for new results, status check, etc.
  • [Tools]

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(c) TMIT Consulting, LLC 2014