MD Care Transitions and Hospital Discharge

Care transitions become more easily understood when broken down by discipline specific providers.  The Wisconsin's PATH ALONG model https://www.facebook.com/pages/PATH-ALONG/423669527722964?ref=hl delivers the information in a comprehensible structure.

Community members involved with a hospital stay soon find they are being seen by more than one medical doctor.  The senior will have their primary medical doctor who they will see in the family clinic, and the hospital will have a doctor on staff for the inpatient treatment process.  The PATH ALONG model views this care transition like this:

 Hospitalist     (transition)     Primary MD

Dynamic component- ongoing monitoring tasks requiring an MD order are communicated to the Primary MD

Rationale: rapid care through primary MD helps prevent a rehospitalization

Consider a family member being prescribed an anti seizure medication as part of their hospital treatment.  The patient is discharged with a script for anti seizure medications to be filled by the corner drug store for in home consumption.  Part of this new anti seizure medication is the ongoing blood draws to allow the lab to determine the therapeutic dose.  The lab will require an MD order to conduct the needed on going blood draws. 

The family clinic can get the MD order to the lab and schedule the ongoing blood draws which will be an important part of this new anti seizure treatment.  The primary MD will be the provider who assesses and monitors the patient's response to the newly prescribed treatment regimen. 

The Centers for Medicare and Medicaid (CMS) believe closer attention to care transitions is the means to reduce the need to return to the hospital for additional help. 

 You are cordially invited to download your free PATH ALONG app today

http://appsmakerstore.com/appim/j6kcdet8xvwk4s

Home Care Path (www.homecarepath.com) received a Healthy Community Partnership Grant from St. Clare Health Care Foundation to demonstrate how attention to care transitions can keep families from having to run back and forth to the hospital.  This is a free event and everyone is invited to attend.  This includes Pizza from 2 Brother's Pizza and Buffet 221 Broadway Wisconsin Dells  https://www.facebook.com/2BrothersPizzaBuffet

Date and Location of free presentation to simplify care transitions

 Monday August 19, 2013 - 1 pm
Baraboo Senior Center (Civic Center)
124 Second Street, Baraboo WI 53913

          PLEASE  PLAN  TO  ATTEND!!!