Conversation Guide to Improve COVID-19 Vaccine Uptake

IHI – Institute for Healthcare Improvement

This guide is intended to help health care staff and leaders have trust-building conversations about the COVID-19 vaccine, both at work and at home. Exploring people’s feelings about the vaccine through respectful, trust-building interactions over time offers the potential to increase the uptake of vaccinations. The guide helps health care staff and leaders begin to quickly engage in effective conversations about COVID-19 vaccination, enabling learning in practice and resolving issues that arise from such conversations. The focus is on having rich conversations to listen and learn about reasons and feelings for not getting vaccinated — and then seeking to have a dialogue about questions and concerns so that people can consider COVID-19 vaccination.

BOOST: Better Outcomes for Older Adults Safe Transitions

Society Hospital Medicine (SHM)

Evidence-based bundled intervention for hospitals to use to identify patients at high risk for readmission and guide the discharge plan based on identified needs assessed upon hospital admission; provides the patient a Transitional Record to guide them during the post-acute period.

Cost associated with implementation.

GRACE Team Care Model: Geriatric Resources for Assessment and Care of Elders (GRACE)

Agency Healthcare Research and Quality (AHRQ) & Indiana University School of Medicine’s Center for Aging Research

Designed as a promising solution to the health and health care challenges faced by low-income seniors with multiple chronic conditions, researchers at Indiana University developed the GRACE Team Care model  to assist primary care physicians (PCPs) working with low-income seniors to optimize health and functional status, decrease excess usage of health care services, and prevent unnecessary long-term nursing home placement.

IHI STAAR Root Cause Analysis Tool

Institute for Healthcare Improvement (IHI)

Chart Reviews of Patients Who Were Readmitted: This Root Cause Analysis (RCA) tool is one of those that we recommend for hospitals.

Conduct chart reviews of the last five readmitted patients. Reviewers should be physicians or nurses from the hospital and community settings. Reviewers should not look to assign blame, but rather to discover opportunities to improve the care of patients.

Project RED (Re-Engineered Discharge)

Project RED is supported by grants from the Agency for Healthcare Research and Quality (AHRQ) and the National Institutes of Health (NIH)-National Heart, Lung and Blood Institute (NHBLI), the Blue Cross Blue Shield Foundation, and the Patient-Centered Outcomes Research Institute.

Hospital based care transition model that coordinates the patient’s discharge plan throughout the hospitalization and then provides a post-acute discharge guide and follow-up telephone calls.

Project Re-Engineered Discharge is a research group at Boston University Medical Center that develops and tests strategies to improve the hospital discharge process in a way that promotes patient safety and reduces re-hospitalization rates. The RED (re-engineered discharge) intervention is founded on 12 discrete, mutually reinforcing components and has been proven to reduce rehospitalizations and yields high rates of patient satisfaction.  Virtual patient advocates are currently being tested in conjunction with the RED. In addition, Project RED has started to implement the re-engineered discharge at other hospitals serving diverse patient populations. We are also looking at the transitional needs from inpatient to outpatient care of specific populations (i.e., those with depressive symptoms). Finally, we are about to start a patient-centered project to create a tool that hospitals can use to discover factors (i.e., medical legal, social, etc.) in patients’ readmissions.

Opioid Overdose Prevention TOOLKIT & Opioid Use Disorder Facts

Substance Abuse and Mental Health Services Administration (SAMHSA)

This toolkit offers strategies to health care providers, communities, and local governments for developing practices and policies to help prevent opioid-related overdoses and deaths. Access reports for community members, prescribers, patients and families, and those recovering from opioid overdose.

  • Scope of the Problem
  • Strategies to Prevent Overdose Deaths
  • Resources for Communities

Strategically Advancing Patient and Family Advisory Councils in New York State Hospitals

Institute for Patient and Family Centered Care (IPFCC)

The purpose of this project is to address gaps in knowledge about PFAC best practices. Specifically, the project aims to:

  1. Determine the prevalence of hospital-based PFACs in New York State;
  2. Document variation in hospital-based PFACs within New York State, including identifying differences in characteristics such as composition, structure, resources, management, and functioning;
  3. Assess the extent to which differences in hospital-based PFAC characteristics are related to selected outcomes, including safety and patient experience of care;
  4. Identify best practices for PFACs; and
  5. Recommend policy and practice changes for New York State to facilitate the spread of effective PFACs and PFA roles in hospitals

Your Guide to Controlling & Managing Pain After Surgery

MHA Keystone Center

Provides education to patients related to:

  • Understanding surgical pain
  • Understanding pain after surgery
  • Questions to ask before surgery, after surgery and before discharge
  • Tools to help manage pain
  • Keeping track of pain medications and frequency
  • Common pain medication side effects

Partnering with Patients and Families to Strengthen Approaches to the Opioid Epidemic

Institute for Patient and Family Centered Care (IPFCC)

This whitepaper showcases the many opportunities for patients, families, and individuals with lived experience to collaborate in shaping and implementing policies and programs related to the opioid epidemic. While work in this area is evolving, several “spotlight examples” provide a starting point for thinking about new strategies and opportunities and reflect existing structures that can be utilized and expanded to accelerate the process of building meaningful partnerships.

Hospital Roadmap for Person and Family Engagement (PFE): Achieving the Five PFE Best Practices to Improve Patient Safety and Health Equity

American Institutes for Research (AIR)/IPRO HQIC

This PFE Roadmap provides practical guidance to help hospitals implement five PFE best practices:

  1. Implementation of a planning checklist for patients who have a planned admission
  2. Implementation of a discharge planning checklist
  3. Conducting shift change huddles and bedside reporting with patients and families
  4. Designation of a PFE leader in the hospital
  5. Active Person and Family Engagement Committee or other committees where patients are represented and report to the board

Patient Family Advisory Councils Toolkit

Colorado Hospital Association

With the shift in the health care landscape from volume to value, more hospitals are engaging patients in their everyday hospital activities. Like any profession, learning from the consumer can provide great insight on how to provide better service. Integrating patient and family advisory councils (PFACs) within the hospital setting is an excellent approach to learn from patients and increase the quality of care delivered in a hospital. The toolkit underscores PFAC support with quality and safety, patient satisfaction, patient outcomes and market share.

Designing and Delivering Whole-Person Transitional Care; The Hospital Guide to Reducing Medicaid Readmissions

Agency for Healthcare Research and Quality (AHRQ)

Reducing readmissions is a national priority for payers, providers, and policymakers seeking to improve health care and lower costs. Readmissions are a significant issue among patients with Medicaid. The Agency for Healthcare Research and Quality (AHRQ) commissioned this guide to identify ways evidence-based strategies to reduce readmissions can be adapted or expanded to better address the transitional care needs of the adult Medicaid population. The guide has been field tested by individual hospitals and groups of hospital quality improvement collaboratives. Based on a series of coaching and feedback calls with hospitals, the second release of this guide has been updated to provide updated tools and clearer guidance on who should use the tools and what to do with the output of the tools. It also offers new tools that can be used in the day-to-day working environment of hospital-based teams and cross-setting partnerships.