INSPIREd Healthcare

A Value-Based Care Coordination Model

Billie Lynn Allard

• Publisher: Sigma Theta Tau International
• Year: 2020
• eBook ISBN: 9781948057318
• Edition: 0
• Topic: Medicine
• Subtopic: Nursing

In today's environment where healthcare costs are outpacing the economy, healthcare systems are shifting from fee-for-service to value-based payment to deliver high-quality care while reducing costs. This shift presents nurses with the opportunity to take the lead in transforming care delivery and achieve the Triple Aim goals: improving patient experience of care, improving health of populations, and reducing per capita healthcare costs. INSPIREd Healthcare follows author Billie Lynn Allard and her team of nurses as they successfully implement an accountable community of health in pursuit of the Triple Aim. The INSPIRE Model they follow provides an evidence-based blueprint for other healthcare systems hoping to solve the complicated problems surrounding care transitions and health promotion

Table of contents

• Cover
• Endorsements
• Title Page
• Copyright Page
• Dedication
• Acknowledgments
• About the Author
• Contributing Authors
• Table of Contents
• Preface: A Note From the Chief Financial Officer
• Foreword
• Introduction
• Part 1: The Road to Inspire
• Part 2: Inspire Across the Care Continuum
• Appendix A: Mapping Out Workflows With Community Partners: Strategy to Build Teamwork, Trust, and Accountability With Blueprint for Health
• Appendix B: Transitional Care Nursing
• Appendix C: Role Clarification for: Hospital-Based Case Manager, Blueprint for Health Medical Home Nurse Case Manager, Transitional Care Nurse
• Appendix D: Transitional Care Nurse Orientation
• Appendix E: Transitional Care Launch
• Appendix F: Examples of Patient Education Tools Created by Interdisciplinary Team Focused on Care Coordination for COPD
• Appendix G: Structure to Maximize Efficiency for ID Rounds Held Daily at 9 a.m. to Review All Inpatients in Med Surg, ICU
• Appendix H: Brochures for Transitional Care Program
• Appendix I: Transitions of Care Annual Reports
• Appendix J: Community Care Team Annual Reports
• Appendix K: Community Care Team
• Appendix L: Pediatric Community Care Team Annual Report
• Appendix M: Pulmonary Rehabilitation Reports
• Appendix N: Diabetes Education Annual Reports
• Appendix O: Medication Therapy Management Annual Report
• Appendix P: Youth Screening, Brief Intervention, Referral to Treatment (YSBIRT) Age 12-24 Years
• Appendix Q: Pediatric Community Care Team
• Appendix R: Transitions of Care Program Consent Forms
• Appendix S: Transitional Care Patient Satisfaction Tool
• Appendix T: Strategy for Food Insecurity
• Appendix U: Sample ANCC Abstract
• Appendix V: Strategy to Disseminate Nursing and Clinical Innovation Supported by Grant Funds
• Appendix W: Palliative Care Annual Report
• Appendix X: RiseVT Statewide Wellness Initiative
• Appendix Y: Healthy Home Program
• Appendix Z: Healthcare Regulations
• Index