Transitions of Care: Reducing 30-Day Readmissions Without a New FTE
- 0:00 Why Readmissions Start Early
- 9:00 Find The Highest-Risk Patients
- 19:00 Fix The Handoff Chain
Practical shifts you can apply this week
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Identify Transition Failure Points
Spot the breakdowns in risk recognition, meds, and follow-up that drive avoidable 30-day returns.
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Compare High-Effort Discharge Activities
See which common tasks add noise and which few interventions consistently move readmission rates.
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Diagnose Patients Needing Intensive Transition Support
Use practical signals already in the chart to focus scarce time where it matters most.
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Design A No-New-FTE Transition Workflow
Clarify who does what across inpatient, pharmacy, and ambulatory teams before gaps turn into bounce-backs.
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Draft A 90-Day Test Plan
Leave with measures, escalation rules, and checkpoints you can use on one unit next month.
What we'll cover
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0:00
Why Readmissions Start Early
A quick look at where avoidable returns begin, often well before the discharge paperwork circus.
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9:00
Find The Highest-Risk Patients
Use utilization, meds, social barriers, and diagnosis triggers to tier support instead of treating everyone the same.
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19:00
Fix The Handoff Chain
Map ownership across PCP, SNF, home health, and referrals so critical information lands within 24 hours.
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29:00
Medication Reconciliation That Works
Reduce discrepancies, access barriers, and confusion before discharge and again in the first week.
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39:00
Build Follow-Up Into Workflow
Design 7-day follow-up, outreach, and escalation into standard work rather than hoping patients manage it alone.
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48:00
Redeploy Capacity, Not Headcount
Cut low-yield tasks, standardize scripts, and move work to the lowest effective license level.
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55:00
Pilot, Recap, And Q&A
Turn the framework into a 90-day test plan, review key takeaways, and leave with a clear next step.
Questions people ask before registering
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It is built for working professionals involved in care transitions, operations, quality, case management, pharmacy, nursing, and ambulatory follow-up. If readmissions land on your dashboard or your to-do list, it should feel relevant.
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No special prerequisites are required. We use plain language, practical workflow examples, and risk signals already found in the record.
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Yes, a replay is typically shared with registered attendees after the session. That said, joining live makes it easier to ask questions about your own workflow.
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Tactical. You will see specific failure points, handoff steps, medication touchpoints, and a simple 90-day pilot structure you can adapt quickly.
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A certificate of attendance may be available depending on the host's setup. CE credit should not be assumed unless it is explicitly listed on the registration page.
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No. The focus is workflow redesign, risk targeting, and clearer ownership using existing teams and tools. New headcount is not the premise.