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Resources > Care Transitions

Care Transitions

We are pleased to offer the following resources related to care transitions.  To view a document, click on it.  To save it to your computer, right click on it.

Resources are updated frequently, so check back for more information.

View a recording of the WebEx, "Planning Ahead for Health Care Decisions - It's all about the conversations" and the accompanying handouts.

View a recording of the WebEx, "Planning Ahead for Health Care Decisions - It's all about the converstations - Part II"

Document name SortDescriptionModified
 .pdfCare Transitions Pillars
A document with the 4 pillars of the care transitions intervention coaching activities and processes.08/11/2011
 .docChart_Review_Audit_Tool_Hospital
Chart Review Audit Tool03/28/2012
 .pdfCoaching poster
10 facts physicians need to know about coaches. 08/11/2011
 .pdfCoaching Script
A suggested script to follow as a care transition coach. 08/11/2011
 .docCommunity_Coalition_Charter
Sample coalition charter04/20/2012
 .pdfCommunity_Preparedness_Checklist
Community Preparedness Checklist11/18/2011
 .pdfCommunity-Building-Puzzle-Tool
Community Building Puzzle Tool02/17/2012
 .pdfCross Setting Transfer Form
Modifiable cross setting discharge/transfer form. 08/11/2011
 .pdfEvidence-Based-Care-Transition-Models
Evidence-Based Care Transition Models03/13/2012
 .pdfICP-Recruitment
Integrating Care for Populations Project Requisites02/13/2012
 .pdfInpatient_Facility_Interventions
Inpatient Facility Interventions12/05/2011
 .pdfIntegrating-Care-for-Populations--AIM
Integrating Care for Populations Overview02/13/2012
 .pdfInterventions_by_Driver
Interventions by Driver Table11/18/2011
 .pdfPersonal Health Record Poster
The top 10 reasons a patient should create a personal health record. 08/11/2011
 .pdfPhysician Follow Up Poster
The top 10 reasons you need physician follow up within 7 days of discharge. 12/22/2011
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