Transitional Care Partnerships: Improved Communication & Care Coordination Across the Healthcare Continuum

Originally presented on December 15, 2016

Sara Butterfield, RN, BSN, CPHQ, CCM
Senior Director, Health Care Quality Improvement Program, IPRO

Patricia LeGasse
Quality Assurance Coordinator, Niagara Falls Memorial Medical Center

One of the chief goals of health care reform is to improve quality and cost effectiveness by reducing fragmentation across providers and systems. Improving provider communication, coordination and patient care continuity will help to ensure that patients receive high-quality care and prevent unnecessary hospital readmissions. This webcast will focus on why cross-setting collaboration across all healthcare provider and community service settings is important for achieving improved outcomes. Webcast speakers will review the driving forces for improved transitional care management and patient/caregiver activation at the local, state and national levels and discuss strategies to include caregivers in the care transition team. Examples of organizational culture change and patient/caregiver activation will also be discussed, with an emphasis on improving patient outcomes through development of strong partnerships across the healthcare continuum and expansion of caregiver roles that promote successful community living.

Learning Objectives
After watching this webcast participants will be able to:

  • Discuss forces driving re-hospitalization at the national and statewide level;
  • Identify the importance of cross-setting collaboration for improved communication, information transfer and patient/caregiver activation and engagement; and
  • Describe strategies for involving caregivers in the discharge planning process.

To Obtain Continuing Education Credits: 
Each participant interested in CE credits must complete an evaluation and post-test, which is available above under "Evaluation, Post-test & Credits". A score of 80% and above on the post-test will generate a certificate indicating the requested credits.

The planners, moderator, and presenters do not have any financial arrangements or affiliations with any commercial entities whose products, research or services may be discussed in this activity.

No commercial funding has been accepted for this activity.

Continuing Medical Education Credits

The School of Public Health, University at Albany is accredited by the Medical Society of the State of New York (MSSNY) to provide continuing medical education for physicians.

The School of Public Health, University at Albany designates this enduring material for a maximum of 1.0 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

Continuing Medical Education Credits are offered until December 31, 2019.

Continuing Nurse Education Contact Hours

The University at Albany School of Public Health is an Approved Provider of continuing nurse education by the Northeast Multi-State Division, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

This offering is approved for 1 nursing contact hour(s).

Nursing Contact Hours are offered until December 31, 2019.

Certified Health Education Specialist Contact Hours

Sponsored by the School of Public Health, University and Albany, SUNY, a designated provider of continuing education contact hours (CECH) in health education by the National Commission for Health Education Credentialing, Inc. This program is designated for Certified Health Education Specialists (CHES) and/or Master Certified Health Education Specialists (MCHES) to receive up to 1.0 total Category I contact education contact hours. Maximum advanced-level continuing education contact hours available are 0.

Continuing Education Contact Hours are offered until December 31, 2019. 

Social Work

University at Albany, School of Social Welfare is recognized by the New York State Education Department's State Board for Social Work as an approved provider of continuing education for licensed social workers #0011.

This offering is approved for 1 social work self-study continuing education hour.

Social Work continuing education hours are offered until December 31, 2019.