CDC Guideline for Prescribing Opioids for Chronic Pain

Centers for Disease Control (CDC)

Provides recommendations for the prescribing of opioid pain medication for patients 18 and older in primary care settings. Recommendations focus on the use of opioids in treating chronic pain (pain lasting longer than 3 months or past the time of normal tissue healing) outside of active cancer treatment, palliative care, and end-of-life care. The guideline addresses patient-centered clinical practices including conducting thorough assessments, considering all possible treatments, closely monitoring risks, and safely discontinuing opioids. 

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.

Strategy 4: Care Transitions From Hospital to Home: IDEAL Discharge Planning

Agency for Healthcare Research and Quality (AHRQ)

Discharge from hospital to home requires the successful transfer of information from clinicians to the patient and family to reduce adverse events and prevent readmissions. Engaging patients and families in the discharge planning process helps make this transition in care safe and effective. Strategy 4: Care Transitions From Hospital to Home: IDEAL Discharge Planning highlights the key elements of engaging the patient and family in discharge planning.

Taking Care of Myself: A Guide for When I Leave the Hospital

Agency for Healthcare Research and Quality (AHRQ)

A guide that providers can use to give patients the information they need to help them care for themselves when they leave the hospital. Using this easy-to-read guide with patients during discharge can help them care for themselves when they leave the hospital to track their medication schedules, upcoming medical appointments, and important phone numbers.

Re-Engineered Discharge (RED) Toolkit

Agency for Healthcare Research and Quality (AHRQ)

A variety of forces are pushing hospitals to improve their discharge processes to reduce readmissions. Researchers at the Boston University Medical Center (BUMC) developed and tested the Re-Engineered Discharge (RED). Research showed that the RED was effective at reducing readmissions and posthospital emergency department (ED) visits. The Agency for Healthcare Research and Quality contracted with BUMC to develop this toolkit to assist hospitals, particularly those that serve diverse populations, to replicate the RED.