Integrating Care Improves Patient Outcomes
The movement of a patient from
one health care setting to another, or the need for a patient to see more than
one physician or provider at a time can be challenging for both providers and
Education for the patient
and family, cooperation between providers, quality care that is well
coordinated, and the timely transfer of critical clinical and lifestyle information
can lead to a successful and satisfying patient experience.
HAP and its member organizations, including rehabilitation,
behavioral health, long-term care, hospice, and trauma facilities are working
together to improve patient transitions between providers and care outcomes
HAP is convening collaborative meetings with medical rehabilitation
facilities, long-term care facilities, home health organizations, and behavioral
health facilities to discuss a migration from the current model of care
delivery, where silos exist, to a collaborative model that builds and
strengthens partnerships between each stage of pre- or post-acute care.
Improving Access to Behavioral
The Affordable Care Act supports new health care delivery models that
will better serve behavioral health patients by coordinating and managing all
health care needs of an individual. HAP is working to secure additional state
and federal funds to initiate new behavioral health care models in the state.
HAP also is advocating for the use of advanced practice professionals in the
behavioral health care setting to preserve access in high-utilization and
under-served areas. HAP will continue to assist hospitals with outreach and
enrollment to get coverage for uninsured behavioral health patients.
Maintaining Access to Trauma
centers provide highly skilled teams of medical specialists to provide care
during and after an occurrence of trauma. Up to 16 physicians in various
specialties are on standby, and nursing teams are ready in the operating room
and critical care units. Due to patient mix, trauma centers have higher levels
of uncompensated care than many other hospitals.
HAP is committed to advocating
for adequate funding to support the specialized care trauma centers provide,
and to ensure there is an adequate supply of physicians, nurses, and other
health care personnel to support these intensive health care services.
Readmissions may occur as
the result of poor communication during the discharge process or during patient
transfer to another care setting; lack of patient resources for follow-up care
or medication; or challenges caring for a patient with complex needs at home or
in other care settings.
HAP and the Pennsylvania Hospital Engagement
Network have teamed up with health care providers to reduce preventable hospital readmissions. A key area of focus is finding better
ways to share information with a patient’s other health care providers to
ensure that there is a clear care plan.