Simino Boyce Patricia, Feldman Penny Hollander
Visiting Nurse Service of New York, 107 E. 70th Street, New York, NY 10021, USA.
Home Health Care Serv Q. 2007;26(4):105-20. doi: 10.1300/J027v26n04_08.
The Reducing Acute Care Hospitalization (ReACH) National Demonstration Collaborative is a two-year multi-wave initiative using a "virtual" Collaborative Learning Model to reduce acute care hospitalization rates among home care patients. ReACH aims to reduce hospitalization to 23%, as recommended by the Centers for Medicare and Medicaid Services in its 8th Scope of Work for Quality Improvement Organizations. This article reports on the early implementation experience of a sample of 17 of 65 home health agencies participating in Wave I of ReACH. It examines agency challenges in implementing a structured practice improvement initiative, improving hospital to home transitions and focusing appropriate resources on high risk patients. Lessons learned will inform future home health care quality improvement initiatives.
降低急性护理住院率(ReACH)全国示范协作项目是一项为期两年的多阶段倡议,采用“虚拟”协作学习模式来降低家庭护理患者的急性护理住院率。ReACH旨在按照医疗保险和医疗补助服务中心在其第8份质量改进组织工作范围内的建议,将住院率降低至23%。本文报告了参与ReACH第一阶段的65家家庭健康机构中的17家机构的早期实施经验。它探讨了机构在实施结构化实践改进倡议、改善医院到家的过渡以及将适当资源集中于高风险患者方面所面临的挑战。吸取的经验教训将为未来的家庭医疗保健质量改进倡议提供参考。