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As part of a comprehensive program to manage care transitions for its complex patients, Stanford Coordinated Care, a part of Stanford Hospital and Clinics, is conducting home visits among its high-risk patients.
Stanford Coordinated Careís clinical nurse specialist, Samantha Valcourt, MS, RN, CNS, developed and implemented the home visits program as part of its care transitions initiative.
Listen to pre-conference comments from Samantha Valcourt.
During Home Visits: Assessing Complex Patients Post-Discharge To Reduce Readmissions, a 45-minute webinar on December 19th, now available for replay, Ms. Valcourt shares the key features of Stanfordís Coordinated Care's care transitions program with a special focus on how they use a home visit assessment to improve care transitions post-discharge.
You will learn:
- The timing and process that Stanford Coordinated Care follows for setting and conducting the home visit;
- The key steps in evaluating risk factors in the home for high-risk patients;
- The number one issue uncovered during home visits that may lead to readmissions; and
- How an interdisciplinarian team, including a highly functioning medical assistant, embedded within the clinic supports the home visit function and improves care transitions.
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||Four serious medication discrepancies can be uncovered when Stanford practitioners visit high-risk patients in the home.