Reducing Readmissions Part 2: Evidence-Based Strategies

Course overview

This course is designed to equip learners with the knowledge to identify and apply major evidence-based models, such as Project RED, the Care Transitions Intervention (CTI), and Project BOOST, to reduce hospital readmissions. A core component of the training is the application of risk stratification tools like LACE, HOSPITAL, and PATIENT scores to efficiently target high-risk patients with appropriate interventions. Finally, the course examines common implementation barriers, like organizational silos and communication gaps, and provides strategies for integrating these practices into transitional care and case management workflows, reinforcing the case manager's essential role in leading these quality improvement efforts.