May 30, 2023 - 12:00 PM - 1:00 PM

Break the Cycle of Rehospitalization by Optimizing Care Transitions Across the Continuum

Location: Online

Registration Deadline: May 30, 2023



Thanks to the underwriting support of HAPevolve and Real Time Medical Systems, a HAPevolve industry partner, this webinar is complimentary for all HAP members.

Traditional approaches to patient transitions from acute to post-acute care typically consist of the transfer of the patient, a stack of paperwork, little to no report, and limited interaction between settings. This can lead to unnecessary complications such as medication errors and preventable infections. The introduction of value-based payment models and penalties for hospital readmissions has motivated providers to improve transitions to post-acute facilities and home-based care, but challenges remain. 

This session explains how post-acute analytics helps break down communication silos to connect health care organizations, optimizing transitions of care and patient management. Participants will learn how leveraging live data from their post-acute partners enables them to identify the most appropriate post-acute care setting based on the patient’s needs, enhance care coordination and patient education efforts, and define standards of care based on clinical pathways. Working together from the same data, acute and post-acute providers can also improve clinical outcomes by setting shared goals, establishing a discharge date and plan, and understanding the level of rehabilitation patients need. We will explore how data transparency with post-acute partners provides hospital care teams clinical line of sight to ensure patients are managed effectively in place, breaking the cycle of rehospitalization.

Learning Objectives

At the conclusion of this webinar, participants will be able to:

  • Discover how live data transparency informs and facilitates effective care coordination and discharge planning between acute and post-acute providers
  • Explain how leveraging post-acute analytics to risk stratify and prioritize patients enhances collaborative care and reduces rehospitalization risk
  • Develop strategies to implement data-driven standardized care pathways to reduce variability in care


Phyllis Wojtusik, RN
Executive Vice President, Health System Solutions
Real Time Medical Systems

With over 35 years of health care experience in acute care, ambulatory care, and post-acute care, Phyllis Wojtusik has managed the development of post-acute networks, participated in the Medicare Shared Savings Program and other value-based contract programs. Prior to joining Real Time Medical Systems, Phyllis led the development of a preferred provider SNF network for Penn Medicine Lancaster General Health. Within this network, she developed and implemented strategies that reduced total cost of care and readmissions while improving quality measures and patient outcomes.

Phyllis also has experience in physician practice management and worked for more than 15 years in a leadership role for a large successful geriatric practice that expanded from two physician providers to more than 30 physicians and CRNPs. She also led the development and coordination of a Geriatric Assessment program that focused on dementia diagnosis, treatment, and management.

Phyllis’ clinical background includes spending 12 years in critical care as a nurse, nurse manager, and case manager. Phyllis speaks nationally and regionally on transitions of care, care coordination, and post-acute network development and management. As a graduate from Lancaster General School of Nursing and Franklin and Marshal College, Phyllis holds degrees in nursing and science.

Who Should Attend

This webinar will be of interest to clinical leaders, care coordinators, nurse navigators, and chief executive officers.

Registration Information


Although this webinar is complimentary for HAP members through underwriting support of HAPevolve and industry partner Real Time,  you must register to attend.



For registration information, or if you need special accommodations, please contact HAP Education Services at (717) 561-5270.

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