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Cost & Quality

Improving Care Transitions: Collaborative Partnerships and Interventions

Due to ongoing efforts to hone patient care and achieve better organizational reimbursement, improving the process of transitioning patients between healthcare settings is becoming increasingly important for industry leaders. Not only do effective care transitions improve patient care continuity, they also help to reduce and prevent avoidable readmissions. In their efforts to provide seamless care transitions between settings, many leaders are developing stronger partnerships with outpatient specialty care facilities and skilled nursing centers.

Founded in 2012 by an academic health system in Wisconsin, the Skilled Nursing Facility Acute Care Coalition is a collaborative network of skilled nursing facilities in the health system's service area. In order to learn more about how the coalition has successfully performed and managed patient transitions across the care network, The Academy spoke with the organization's director of transitional care.

Collaborative Partnerships
Formed and led by the director, the Skilled Nursing Facility Acute Care Coalition began with small focus groups assessing the nursing facilities’ interest in partnering with the health system to improve care transit

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