Collaborative Case Management - Issue 76 - A peer-reviewed journal from ACMA

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ISSUE 76

COLLABORATIVE CASE MANAGEMENT | ACMAWEB.ORG

Shared Care Alerts: Reducing Avoidable Utilization and Improving Care Coordination and Outcomes Across the Continuum of Care Authors: Pamela Garvin BSN, RN; Sarah Greenwood BSN, RN; Cynthia Gingrich MSIM, PMP, CPHIMS; Emily Schneider LCSW-C; Cynthia Seen BSN, RN; Elizabeth Tingo MSN, RN, CMC

LEARNING OBJECTIVES 1. Discuss the program and project description. 2. Identify how shared Care Alerts can help patients and health care providers. 3. Share the outcomes of shared Care Alerts.

BACKGROUND In 2015, The Maryland Health Services and Cost Review Commission (HSCRC) released a Request for Proposal (RFP) and associated Regional Partnership Transformation Planning grant, focused on bringing hospitals and community partners together to reduce

avoidable utilization, expand care coordination and support services and improve outcomes for patients who were high utilizers (HU) of hospital and ED services. The University of Maryland Baltimore Washington Medical Center (UM BWMC) and Anne Arundel Medical Center (AAMC) joined together to form the Bay Area Transformation Partnership (BATP) along with several community organizations. The grant was used to study cross-organizational, multidisciplinary gaps in data and communications, and to develop solutions. The partnership also received a subsequent four-year ‘Transformation Implementation’ grant to implement the tools and services identified through the planning grant.

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