Quality of Care Transitions
Better Together.Patients transitioning between healthcare settings or home are especially vulnerable. Effective communication is essential to maintain patient safety and reduce adverse events.
Shifting care between healthcare facilities or to the patient and their family or caregivers is difficult, especially for those managing complex health conditions and multiple medications.
- One study estimates that 80% of serious medical errors involve miscommunication during the hand-off between medical providers.
- Nearly half of all American adults—90 million people—have difficulty understanding and acting upon health information.
- People affected by multiple chronic conditions are at risk of early mortality, poor functional status, and hospitalization. They also face significant out-of-pocket expenses for healthcare and prescription drugs.
Continual communication among the patient, their providers and their caregivers ensures individual medical needs, health status, and personal values are addressed, especially during care transitions. Promoting shared decision making methods, hospital discharge protocols and risk assessments would ensure patient safety and improve the overall patient experience.
Quality Care Transition News
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Quality Care Transition Training Events
Most likely, dementia does not increase risk for COVID-19, the respiratory illness caused by the new coronavirus, just like dementia does not increase risk for flu. However, dementia-related behaviors, increased age and common health conditions[...]
![Great Plains Quality Care Coalition Webinar - Getting Started [CANCELED] @ Webinar - Getting Started](https://greatplainsqin.org/wp-content/uploads/2017/04/Chalkboard-teamwork1280x300-2-300x70.jpg)
Great Plains Quality Care Coalition Webinar – Getting Started [CANCELED] Please Join Us. Better together! Learn more about Great Plains Quality Care Coalition (GPQCC). Our team of quality improvement experts will outline the[...]
Great Plains Quality Care Coalition Webinar – Getting Started Please Join Us. Better together! Learn more about Great Plains Quality Care Coalition (GPQCC). Our team of quality improvement experts will outline the format[...]
This year’s Quality Health Associates of North Dakota Annual Quality Forum—The Power of Progress—is an intentional celebration of successes from across the continuum of care throughout North Dakota represented by professionals who are[...]
Overview and Purpose: Vaccine hesitancy has been identified by the World Health Organization (WHO) as one of the ten threats to global health in 2019, potentially having broad implications reaching beyond the typical vulnerable populations.[...]
Presentation/Slides Handout Webinar Q&A’s [youtube https://www.youtube.com/watch?v=gctIkAK8f4Y] Overview and Purpose: With the implementation of Patient-Driven Payment Model (PDPM) slated for October 1, 2019, diagnosis coding will become even more important. Skilled nursing facility and hospital diagnoses[...]
[youtube https://www.youtube.com/watch?v=_a9d-ftKQOE] Presentation Handout Improving the Patient Experience Learning and Action Network Series Healthcare is personal. Any individual in need of healthcare services becomes vulnerable. The level of comfort and confidence relayed[...]
Presentation Handout/Slides Overview and Purpose: The recently finalized Patient Driven Payment Model (PDPM) along with the Quality Reporting Program and Value-Based Purchasing Program will have significant impact on long-term care ratings for 2019 and beyond.[...]
Presentation/Slides Handout Bedside medication delivery (Med-to-Bed) involves patients obtaining their discharge medications and education prior to leaving the hospital. It has been found to reduce readmissions and improve patient satisfaction scores. This presentation provided an[...]
Improving the Patient Experience Learning and Action Network Series Healthcare is personal. Any individual in need of healthcare services becomes vulnerable. The level of comfort and confidence relayed by healthcare professionals at every stage of[...]
[youtube https://www.youtube.com/watch?v=DcyTiSnGS8A] Patient Experience Beginner’s Guide Facility Branding: Identify and Impact Public Perception Improving the Patient Experience Learning and Action Network Series Healthcare is personal. Any individual in need of healthcare services becomes vulnerable.[...]
Register Now Participation Instructions: Register for the WebEx event. Upon registration, you will receive a confirmation email with a registration ID from messenger@webex.com. The information on the email will be required to log into the[...]
[youtube https://www.youtube.com/watch?v=vZ53l69UrRY] Presentation Handouts: Beyond First Impressions: Determining Market Impact on Patient Engagement Patient Engagement Case Study Patient Experience: A Beginner’s Guide Overview and Purpose: Marketing in the healthcare industry must reach beyond first[...]
Overview and Purpose: From storms to droughts, wildfires to floods or accidents to epidemics, disasters occur nearly every day in the United States, and the frequency is increasing. How many people are hurt or even[...]
Presentation handout Overview and Purpose: This webinar will provide a brief explanation of antibiograms and will delve into their value in acute care, long-term care and outpatient settings. Using antibiograms to support improved antibiotic use[...]
All healthcare providers, partners and beneficiaries are welcome to attend! This Medication Safety Learning and Action Network (LAN) Event will feature a speaker panel of patients living with pain, a pain management specialist and a[...]
Presentation Handout Discharge Timeout Checklist [youtube https://www.youtube.com/watch?v=aaE1O94vepo] In June 2016, Rapid City Regional Hospital in Rapid City, SD, launched a new method of quality improvement that puts frontline staff in the driver’s seat for[...]
Presentation handout WebEx Q&A Learn how a large system practice and rural clinic practice are using Chronic Care Management Programs to better coordinate care, increase communication to providers, reduce unnecessary hospitalizations and ED visits, empower[...]
Click here to download the brochure Overview and Purpose: Health and quality of life rely on many community systems and factors, not simply on a well-functioning health and medical care system. Making changes can effectively[...]
Presentation Handout Improving care for people with multiple chronic conditions that are often complicated by patients’ limited ability to care for themselves independently and by their complex social needs will help improve the performance of[...]
Presentation Handout Advance Care Planning Resources [youtube https://www.youtube.com/watch?v=ZM8bSz4WVms] This webinar will feature a review of the Institute for Healthcare Improvement’s (IHI) framework for improving end-of-life care which includes five “bite-sized” practical principles. Stories from several[...]
Presentation Slides Handout The CDC Guidelines for Prescribing Opioids for Chronic Pain recommend tapering opioids when benefits do not outweigh harms of continued therapy. Tapering opioids can be challenging and a difficult process for patients.[...]
Presentation Handout Improving care for people with multiple chronic conditions that are often complicated by patients’ limited ability to care for themselves independently and by their complex social needs will help improve the performance of[...]
Presentation/Slide Handout Naloxone is a safe medication that can prevent opioid deaths. This webinar will improve participants’ understanding of the role of naloxone in preventing opioid overdose related death, identification of individuals who may[...]
Presentation/Slides Handout Agency for Healthcare Research and Quality (AHRQ) and the Department of Defense (DoD) have developed TeamSTEPPS, a teamwork system that offers a powerful solution to improving collaboration and communication. Teamwork has been found[...]
Presentation/Slide Handout Early Recognition and Management of Sepis for Post-acute Settings (MPRO) Sepsis is one of the top diagnoses involved with readmissions throughout the Great Plains and Lake Superior Quality Innovation Networks. This webinar is[...]
This webinar will review acute pain and chronic pain guidance and will discuss how to use a pain guidance document in practice. Differentiation of pain treatment recommendations as they relate to patient populations will be[...]
Presentation/Slide Handout On January 1, Nebraska became the first state to require pharmacists and pharmacies to report all dispensed prescriptions daily to the state’s Prescription Drug Monitoring Program (PDMP), not just controlled substances. PDMPs are a[...]
This webinar highlighted the development of a Pain Guidance Task Force in Nebraska. Presenters discussed composition of the task force and utilization of CDC’s guidelines on opioid prescribing to compile the Nebraska Pain Guidance Document[...]
One of the multitude of contributing factors to the opioid epidemic is highly variable pain treatment practices between healthcare providers. Efforts are being made nationally and at organizational levels to provide more consistent treatment guidelines[...]
Presentation Handout Every two minutes someone dies from sepsis in the United States. Eighty percent of sepsis begins outside the hospital. The elderly, as well as patients with chronic conditions, are at significant risk[...]
One of the multitude of contributing factors to the opioid epidemic is highly variable pain treatment practices between healthcare providers. Efforts are being made nationally and at organizational levels to provide more consistent treatment guidelines[...]
Nonpharmacologic therapies have become a vital part of managing chronic pain. This webinar will focus on the non-pharmacologic options available including mindfulness and meditation, yoga and exercise, anti-inflammatory foods, emotional triggers, sleep and more. Target[...]
[youtube https://www.youtube.com/watch?v=zRs41m41DOU] Presentation handout Nonpharmacologic therapies have become a vital part of managing chronic pain. This webinar will focus on the non-pharmacologic options available including mindfulness and meditation, yoga and exercise, anti-inflammatory foods, emotional[...]
Heart failure is one of the top diagnoses involved with readmissions throughout the Great Plains and Lake Superior Quality Innovation Networks. This webinar is the sixth in a series to assist communities in this[...]
Presentation handout While colorectal cancer is preventable, one in three Americans has not been screened. During this Learning and Action event, a patient and healthcare professional panel will share insights and tools to engage[...]
Prescription drug monitoring programs (PDMPs) are a valuable tool to improve patient care and coordination and public safety by reducing drug diversion and inappropriate use. This follow-up coaching call provides participants the opportunity to[...]
Presentation Handouts: Presentation Handout Leadership Team Diagnostic Checklist This event has been approved for 1.0 hour of Continuing Education (nursing) credit through the North Dakota Board of Nursing: Course #1573 During this WebEx,[...]
Prescription drug monitoring programs (PDMPs) are a valuable tool to improve patient care and coordination and public safety by reducing drug diversion and inappropriate use. This event includes PDMP staff from throughout the Great Plains[...]
Prescription drug monitoring programs (PDMPs) are a valuable tool to improve patient care and coordination and public safety by reducing drug diversion and inappropriate use. This event includes PDMP staff from throughout the Great Plains[...]
Heart failure is a top diagnoses linked to readmissions throughout the Great Plains and Lake Superior Quality Innovation Networks. This webinar is the fifth in a series of webinars to assist communities in this seven-state[...]
Medication Safety LAN Series [youtube https://www.youtube.com/watch?v=OperQauH8GI] An important pillar to reducing abuse of opioids is safe and proper disposal of unused medication. This coaching call will allow participants to interact with take back experts to[...]
Medication Safety LAN Series An important pillar to reducing abuse of opioids is safe and proper disposal of unused medication. This webinar reviews success approaches at the community and state level to improve access to[...]
Medication Safety LAN Series There is no single solution to the opioid epidemic. It will require a collaborative approach with variety of community partners to address factors such as pain management, treatment, and societal impact.[...]
Heart failure is one of the top diagnoses involved with readmissions throughout the Great Plains and Lake Superior Quality Innovation Networks. Providing targeted assistance to Congestive Heart Failure (CHF) patients in the home setting after[...]
Heart failure is one of the top diagnoses involved with readmissions throughout the Great Plains and Lake Superior Quality Innovation Networks. This webinar is the third in a series of webinars to assist communities in[...]
Heart failure is one of the top diagnoses involved with readmissions throughout the Great Plains and Lake Superior Quality Innovation Networks. This webinar is the second in a series to assist communities in this[...]
Overview and Purpose: Key patient-centered care topics will be presented in 15-20 minute webinar segments highlighting provider and clinician perspectives while introducing corresponding resources and tools during the Provider Perspectives on Patient-Centered Care webinar series.[...]
Webinar Playback Overview and Purpose: Key patient-centered care topics will be presented in 15-20 minute webinar segments highlighting provider and clinician perspectives while introducing corresponding resources and tools during the Provider Perspectives on Patient-Centered[...]
Presentation Handout We will add the WebEx recording when available. This WebEx offers real world experience of success in the Million Hearts® Initiative. The Avera St. Benedict’s clinic staff from Parkston, SD provided insight into[...]
Presentation Handout Overview and Purpose: Heart failure is a top diagnosis linked to readmissions throughout the seven states that comprise the Great Plains and Lake Superior Quality Innovation Networks. This webinar is the first in a series [...]
Overview and Purpose: Key patient-centered care topics will be presented in 15-20 minute webinar segments highlighting provider and clinician perspectives while introducing corresponding resources and tools during the Provider Perspectives on Patient-Centered Care webinar series.[...]
Overview and Purpose: Key patient-centered care topics will be presented in 15-20 minute webinar segments highlighting provider and clinician perspectives while introducing corresponding resources and tools during the Provider Perspectives on Patient-Centered Care webinar series.[...]
Overview and Purpose: Key patient-centered care topics will be presented in 15-20 minute webinar segments highlighting provider and clinician perspectives while introducing corresponding resources and tools during the Provider Perspectives on Patient-Centered Care webinar series.[...]
Care Coordination and Medication Safety Progress within the Great Plains QIN Region Join the Great Plains Quality Innovation Network Care Coordination Team for the fifth in this series of action-oriented learning events. This WebEx session will[...]
Overview and Purpose: Key patient-centered care topics will be presented in 15-20 minute webinar segments highlighting provider and clinician perspectives while introducing corresponding resources and tools during the Provider Perspectives on Patient-Centered Care webinar[...]
Teach-back is a communication method used to help patients understand and remember important information. Successful implementation of teach-back has demonstrated better recall and understanding of procedures by patients as well as improved patient satisfaction, medication[...]
Overview and Purpose: Key patient-centered care topics will be presented in 15-20 minute webinar segments highlighting provider and clinician perspectives while introducing corresponding resources and tools during the Provider Perspectives on Patient-Centered Care webinar[...]
This month, the Great Plains QIN is providing the opportunity to participate in a Coaching Call with peers and experts in the field regarding any one of the following three topics: reducing rehospitalizations, medication[...]
Overview and Purpose: Key patient-centered care topics will be presented in 15-20 minute webinar segments highlighting provider and clinician perspectives while introducing corresponding resources and tools during the Provider Perspectives on Patient-Centered Care webinar[...]
Join the Great Plains Quality Innovation Network Care Coordination Team for the fourth in this series of action-oriented learning events. This WebEx session will help your organization build capacity for better, safer care and healthier[...]
Webinar Playback Overview and Purpose: Key patient-centered care topics will be presented in 15-20 minute webinar segments highlighting provider and clinician perspectives while introducing corresponding resources and tools during the Provider Perspectives on Patient-Centered[...]
This month, the Great Plains QIN is providing the opportunity to participate in a Coaching Call with peers and experts in the field regarding any one of the following three topics: reducing rehospitalizations, medication[...]
The Great Plains QIN Care Coordination Team held this third in a series of action-oriented learning events to help organizations build capacity for better, safer care and healthier people and communities. Medication Safety Presentation Handout Medication safety contributes to reducing[...]
This month, the Great Plains QIN is providing the opportunity to participate in a Coaching Call with peers and experts in the field regarding any one of the following three topics: reducing rehospitalizations, medication[...]
Rehospitalizations – Medication Safety – Chronic Disease Management Start WebEx Playback Presentation Handout Recording Transcript Join the Great Plains QIN Care Coordination Team for a series of action-oriented learning events over the next several months[...]
Presentation handout: Outpatient Antibiotic Prescribing Start WebEx Playback In May, the Centers for Disease Control and Prevention (CDC), in collaboration with Pew Charitable Trusts and others, released new data showing that at least 30 percent[...]
Start WebEx Playback Presentation Handout Overview During this WebEx, the presenters shared the unique partnership Park Nicollet Methodist Hospital has created with their local firefighters to conduct home visits on high risk patients that would[...]
MARK YOUR CALENDARS for the next installment of the National Learning & Action Network (LAN) webinar learning series, “Sharing Knowledge, Improving Healthcare.” The session topic will align with the Centers for Medicare & Medicaid Services[...]
All too often patients do not receive the care they wish for as they approach their last days or in medical emergencies. Having conversations about these situations is difficult, but it is critical that these[...]
Start WebEx Playback Webinar Objectives This webinar will be a discussion on strategies to engage community-based programs to support advance care planning. Learn about the Institute for Healthcare Improvement’s (IHI) The Conversation Project[...]
Please Note: This event is 11:30 a.m. Mountain Time or 12:30 Central Standard To participate via phone: 877/662-7634, Passcode 6315499
Please Note: All events are listed in Central Time. To participate via phone: 1-877-662-7634, passcode 6315499
Start WebEx Playback Presentation Handout WebEx Overview This event will provide an introduction to the care coordination and medication safety Learning and Action Network (LAN). Included will be the patient/family perspective, overview of[...]
Please Note: All events are listed in Central Standard Time To participate via phone: 877/662-7634, Passcode 6315499
Start WebEx Playback Presentation Handout AD8 Dementia Screening Interview Behavior Log This program explores key elements in addressing the needs of individuals with dementia who are experiencing behavioral and affective challenges across the care continuum.[...]
Please Note: All events are listed in Central Time To participate via phone: 877-662-7634, Passcode 6315499
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Access to Care Resulting in Hospitalization
Avoidable Emergency Department Visits and Observation Stays
Hospital Admissions/Readmissions
BOOST-Implementation Guide to Improve Care Transitions
Rapid Action Readmission Reduction Collaborative toolkit
Re-Engineered Discharge (RED) Toolkit
RHIhub-Rural Care Coordination Toolkit
Fall Prevention in Hospitals Training Program
Preventing Falls in Hospitals: A Toolkit for Improving Quality of Care
Pressure Injury Prevention in Hospitals Training Program
Preventing Pressure Ulcers in Hospitals
Superutilizer Readmissions and ED Visits
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Great Plains Quality Care Coalition
Our mission is to make healthcare in the Dakotas the best in the nation. We have partnered with committed nursing homes, community leaders and healthcare organizations to improve the care in our communities. Better together.