Change Must Start Somewhere

There are many options for coordination strategies such as:

Patient Navigators

Utilizing patient navigators to:

  • Prompt patients to follow their discharge instructions
  • Encourage filling and taking prescriptions as ordered
  • Coordinate timely access to primary care (or specialist)
  • Find primary care physicians for patients
  • Obtain timely appointments
  • Escalate to nurse or physician as needed
Nurse Outreach

Implement nurse outreach to:

  • Answer additional questions about their care
  • Escalate to NP/PA or physician as required
Supportive Care

Provide supportive care via:

  • Telemedicine
  • Home visits
  • Nurse practitioner or PA visits
  • SNF encounters
  • Return ED visit if needed

Addressing Care in the Gap is critical. Be part of the solution!