Complex Care at NYC H+H: Operational Guide to Identify, Understand, and Treat High-Need Patients

NYC Health & Hospitals

This guide features open-source implementation tools which could be customized, and used to support other health system’s efforts to identify, understand, and treat patients with complex needs.
This guide provides step-by-step guidance on:
1) Risk scoring and stratification: using data and analytics to identify patients with complex needs;
2) Segmentation: combining analytics with clinical insight to understand patients with complex needs; and
3) Targeting: tailoring care models to fit needs and behaviors of patients with complex needs.

THE GLYCEMIC CONTROL IMPLEMENTATION GUIDE: IMPROVING GLYCEMIC CONTROL, PREVENTING HYPOGLYCEMIA AND OPTIMIZING CARE OF THE INPATIENT WITH HYPERGLYCEMIA AND DIABETES

Society of Hospital Medicine (SHM)

Provide users with concise guidance and tips to help them assess their current state of care regarding glycemic control, gain institutional support, build an effective team, choose metrics to follow, implement proven interventions and continue to assess and improve over time.

NUTRITION & IMMUNITY PODCAST SERIES: Pressure Injury

Abbott Nutrition Health Institute (ANHI)

Panel of world-renowned experts discuss nutrition guidelines for caring for COVID-19 patients.

  • NUTRITION CARE FOR PRESSURE INJURIES: GUIDELINES TO OPTIMIZE OUTCOMES
  • THE ROLE OF HYDRATION IN ACUTE INFLAMMATORY PROCESS & RECOVERY
  • NATIONAL BLUEPRINT: ACHIEVING QUALITY MALNUTRITION CARE FOR OLDER ADULTS, 2020 UPDATE
  • NUTRITION SUPPORT OF THE COVID-19 ICU PATIENT
  • A REVIEW OF THE SCCM/ASPEN COVID-19 RECOMMENDATIONS
  • NUTRITIONAL NEEDS OF COVID-19 PATIENTS IN-HOSPITAL & POST-DISCHARGE

2023 National Healthcare Safety Network (NHSN); Patient Safety Component Manual

CDC, National Healthcare Safety Network (NHSN)

The Patient Safety Component includes five modules that focus on events associated with medical devices, surgical procedures, antimicrobial agents used during healthcare, multidrug resistant organisms, and Coronavirus Infectious Disease 2019 (COVID-19).

National Action Plan to Prevent Health Care-Associated Infections: Road Map to Elimination

Office of Disease Prevention and Health Promotion (ODPHP)

In recognition of health care-associated infections (HAIs) as an important public health and patient safety issue, the U.S. Department of Health and Human Services (HHS) convened the Federal Steering Committee for the Prevention of Health Care-Associated Infections (originally called the HHS Steering Committee, but was changed to reflect the addition of agencies outside of HHS). The Steering Committee’s charge is to coordinate and maximize the efficiency of prevention efforts across the federal government. Members of the Steering Committee include clinicians, scientists, and public health leaders representing:

National Action Plans

Agency for Healthcare Research and Quality (AHRQ)

National Action Plans are developed with expert input to provide a framework for collaboration among Government and non-Government entities toward large goals that have significant impact on the Nation’s health.

  • Road Map to Elimination (HAI Action Plan) provides a road map for preventing HAIs in acute care hospitals, ambulatory surgical centers, end-stage renal disease facilities, and long-term care facilities.
  • National Action Plan for Adverse Drug Events identifies the Federal Government’s highest priority strategies and opportunities for advancement and seeks to engage stakeholders in a coordinated, aligned, multisector, and health-literate effort to reduce the ADEs that are most common, clinically significant, preventable, and measurable.
  • National Action Plan on Combating Antibiotic Resistant Bacteria provides a roadmap to guide the Nation in rising to the challenge of antibiotic resistance. It outlines steps for implementing the National Strategy for Combating Antibiotic-Resistant Bacteria and addressing the policy recommendations of the President’s Council of Advisors on Science and Technology.

Reducing Adverse Drug Events Related to Opioids (RADEO) Implementation Guide

Society of Hospital Medicine (SHM)

Provides step-by-step guidance to assist hospital teams in implementing a quality improvement program to improve patient safety and reduce opioid-related adverse events for patients receiving opioids, including:

  • Instituting safer opioid prescribing practices resulting in fewer adverse events, like dangerous over sedation, respiratory depression and death
  • Focusing on hospitalized patients, with essential building blocks for developing a quality improvement initiative addressing the inpatient setting
  • Creating a quality improvement project team in your hospital, gaining institutional support and securing buy-in of frontline staff to ensure successful implementation
  • Developing strategies for evaluating current processes, facilitating policy formation, identifying best practices and tracking progress against implementation goals
  • Optimizing care transitions for patients on opioid therapy in the outpatient setting
  • Exploring a customized approach to address the specific needs of your hospital

Pain Management Toolkit: Iowa’s Guide to Opioid Stewardship

Iowa Healthcare Collaborative

Resources is divided into sections that can stand alone for quick reference. Addresses the real-world situations practitioners face in daily patient care (difficult conversations, non-opioid treatment interventions, acute pain treatment, tapering, chronic pain care, managing ED patients, pain control for cancer and palliative care, etc.)