Our recipes are primers that will help you explore and implement care strategies to benefit your providers, patients, and practice. You can search for the available recipes by keywords, or browse using the filters below.
Improving Transition Care via EHR Hospital Use Data @ Northwestern Medicine Group Transitional Care Clinic
The Northwestern Medicine Group Transitional Care clinic (NMG-TC) seeks to reduce preventable re-hospitalization by implementing a model of intensive case management and integrated behavioral/medical healthcare…
Innovators
- Joe Feinglass PhD
- Celeste A. Mallama PhD MPH
- Angela Rogers MPH, APN-CNP
- Caroline Teter PA
- Courtney Hurt LCSW
- Christine Schaeffer MD
Preventing Readmission via Discharge Readiness Assessments @ Magnet Hospitals
33 magnet-designated hospitals integrated the use of structured nurse assessments of patient readiness for discharge into medical surgical unit discharge practices in an effort to…
Innovators
- James Bang, PhD
- Danielle Siclovan, MSN, RN
- Sarah Bahr, MSN, RN
- Morris Hamilton, PhD
- Susan Nuccio, MSN, RN
- Ronda G. Hughes, PhD, RN
- Olga Yakusheva, PhD
- Kathleen L. Bobay, PhD, RN, NEA-BC
- Linda Costa, PhD, RN, NEA-BC
- Marianne E. Weiss, DNSc, RN
Improving In-Hospital Communication via Smartphones @ University of Maryland
The University of Maryland school of medicine aimed to improve inefficiencies of clinical workflows through implementation of a mobile telephone communication system in a NICU.…
Innovators
- Dina El Metwally
- Samuel Gurmu, MD
- Ahad Azeem
- Colleen A. Hughes Driscoll, MD
Individualized Care Delivery in Primary Care via Integrated Practice Units (IPUs) @ Cambridge Health Alliance Union Square Family Health Center
This intervention sought to adopt integrated practice units (IPUs) into a primary care practice using ‘pod’-based patient care with a multidisciplinary team, disease-oriented patient registries,…
Innovators
- Nina Jain, MD, MBA, MSc
- Toyin Okanlawon, MD, MPH
- Kirsten Meisinger, MD, MHCDS
- Thomas Feeley, MD
Intensive Primary Care via Patient Aligned Care Teams (PACT) Intensive Management @ the Veteran’s Health Administration
The VA currently offers primary care through patient-centered medical homes, or Patient Aligned Care Teams (PACT) for all enrolled Veterans. Selected demonstration sites augmented the…
Innovators
- Evelyn Chang, MD, MSHS
- Lisa Rubenstein, MD, MSPH
Implementing an Interdisciplinary Collaborative Experience in Diabetes Care @ People’s Community Clinic
People’s Community Clinic (PCC) created an interdisciplinary approach to overcome barriers to diabetes self-management by integrating nurses and health educators specialized in diabetes education into…
Innovators
- Elizabeth Washington, RN
Improving Multicultural Depression Screening and Follow-up via Multilingual and Standardized Tools @ Harrisonburg Community Health Center
This quality improvement project aimed to improve depression management by offering both universal screening in several languages and additional tools for treatment decision-making and follow-up…
Innovators
- Diana Jolles, PhD, CNM
- Ann M. Schaeffer, DNP, CNM
Engaging Substance Use Disorder (SUD) Patients in Outpatient Care via Implementation of Recovery Coaches @ Arms Acres
This project aimed to demonstrate the value of adding recovery coaches to the multidisciplinary team at Arms Acres in order to improve transitions of care…
Innovators
- Tamar Wolinsky
- Eric D’Entrone
- Tammy Bender
- Eric Altman
- Damara Gutnick, MD
- Kristin Woodlock, RN
Expanding Nursing Role via RN “Co-Visit” Model @ Clinica Family Health
A multi-site community health center implemented a care model expanding nurses’ roles in intake, documentation, and care plan communication, working alongside providers in “co-visits.”
Innovators
- Karen Funk, MD, MPP
- Malia Davis MSN, RN, ANP-C, NP
Reduction of Opioid Misuse in Primary Care via the Transforming Opioid Prescribing in Primary Care (TOPCARE) Program @ Boston Medical Center
Nurses provide electronic and in-person monitoring of high-risk primary care patients on long-term opioid prescriptions to ensure appropriate use and efficacy of medication.
Innovators
- Jane Liebschutz, MD MPH
- Christopher Shanahan, MD, MPH
- Ronald Goldstein, MD