Reducing Care Fragmentation - A Toolkit FOR Coordinating Care

Improving Chronic Illness Care and MacColl Institute for Healthcare Innovation created the Chronic Care Model, which summarizes the basic elements for improving care in health systems at the community, organization, practice and patient levels. One of the primary goals of care coordination efforts is a high-quality referral or transition. This Toolkit summarizes the elements that contribute to successful referrals and transitions, which include: Assuming accountability, Providing patient support ,Building relationships and agreements among providers and Developing connectivity via electronic or other information pathways. The tool is available as a PDF, requiring Adobe Reader to view the document.

• Details
• Related Solutions

• Category: Operational/Financial Efficiency

• Source: Improving Chronic Illness Care (ICIC)

• Patient Care Process: Care management processes

• Stage of Care: Chronic care

• IOM Domains of Quality: Efficiency

• Tags: Patient Support, Developing connectivity, Building relationships and agreements, Accountability

	Shared Decision Making Toolkit - Specialty Care These toolkits for clinicians help establish a health support center for assisting patients in making health care decisions. The set provides guidelines and examples to be used in specialty care settings for the best decision support a patient would need. The toolkit was developed by Dartmouth-Hitchcock Medical Center. The toolkit is available as PDFs and PowerPoint files, requiring Adobe Reader and Microsoft PowerPoint.
	Shared Decision Making Toolkit - Primary Care These toolkits for clinicians help establish a health support center for assisting patients in making health care decisions. The set provides guidelines and examples to be used in primary care settings for the best decision support a patient would need. The toolkit was developed by Dartmouth-Hitchcock Medical Center. The toolkit is available as web-based components and PDFs, requiring a web browser and Adobe Reader.
	Reducing Care Fragmentation - A Toolkit FOR Coordinating Care Improving Chronic Illness Care and MacColl Institute for Healthcare Innovation created the Chronic Care Model, which summarizes the basic elements for improving care in health systems at the community, organization, practice and patient levels. One of the primary goals of care coordination efforts is a high-quality referral or transition.