How We Improve Care Transitions
We represent the Outpatient Transitions Collaborative (OTC) with transitions program at UNC hospitals identifying readmissions on date of admission. Case Management, nurisng, pharmacy and MD all follow the plan to try to identify reasons for readmission and if it could be prevented. The focus is on identifying additional community supports, reconcilling medications and follow up appointments with PCP.
Our Partners
Internal: Clinics Units, Home Health
External: Community Clinics, SNF’s
Home Health Agencies
Primary Care Offices
How We Measure Our Efforts
Use of A3 for documenting program & metrics 5% reduction in Admissions (OTC – Collaborative Transitions Patients)
15% increase in follow-up visits post discharge
- TypeHealth System, Hospital
- Address10002 Main Street Southern Village 1st Floor, Chapel Hill NC 27516
- Primary Contact NameSabrina Vereen
- Primary Contact Emailsabrina.vereen@unch.unc.edu
- Primary Contact Phone919-595-9389