Improving Transitions of Care (NY)

Improving coordination of healthcare, communication and patient/caregiver knowledge by fostering community-based coalitions, teamwork and patient-centered care.

Patient, Family, Caregiver Resources

IPRO Care Transitions Initiative Resources - Improving transitions of care tools and resources for beneficiaries and families

Helpful Tools for Patients:

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Healthy Seniors Newsletter
The most recent issue of our Healthy Seniors Newsletter is all about improving transitions of care, and includes lots of great information to help you make sure you are getting the care you need when you change from one setting of care to another.
358.9 KiB272
Hospital Discharge Planning Golden Rules
Hospital Discharge Planning Golden Rules provides tips for communication with your primary care doctor when you are hospitalized and helps you to be involved in your discharge plan before leaving the hospital.
52.4 KiB335
Managing Your Heart Failure
Managing Your Congestive Heart Failure shows the important facts about heart failure that you need to understand.
659.0 KiB333
Medication Management Golden Rules
Medication Management Golden Rules gives you the tips and questions you’ll need to make sure you understand the medications you’re taking and to keep track of your current medications and any changes that are made to the plan.
58.3 KiB315
Personal Health Record
A Personal Health Record is a tool for you to use to better self-manage important health information, including health history, medical conditions, medications, allergies and recent hospital and doctor visits. The tool is available in English and Spanish. You should work with your doctor or caregiver to fill out the form.
259.4 KiB287
Registro personal de salud
Personal Health Record in Spanish.
229.5 KiB404
Understanding Medical Language
Ask Me 3 is a program developed by the National Patient Safety Institute to prompt better patient communication with their physicians. This patient-focused article will help you remember to ask three key questions during your care.
150.4 KiB348

Provider Tools and Resources

IPRO Care Transitions Initiative Resources - Improving transitions of care tools and resources for healthcare professionals

Adverse Drug Event Prevention

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Analysis of Warfarin Management: XXXXX Health System XXXX Practice November, 2012 – January, 2013
Analysis of warfarin management
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Anticoagulation Discharge Communication (AC-DC) Audit Tool
Audit tool to evaluate your facility practices regarding communication of requisite anticoagulation‐related elements to subsequent providers upon patient transfer or discharge
208.3 KiB282
Billing Codes
Adverse Drug Event Prevention - Billing codes
144.4 KiB299
Data Elements for Analysis
Data elements for analysis - required and additional elements
155.4 KiB285
Management of Anticoagulation in the Peri-Procedural Period
Management of Anticoagulation in the Peri-Procedural Period A TOOL FOR CLINICIANS
336.9 KiB352
Management of Anticoagulation in the Peri-Procedural Period Tool (MAP) Order Form
Laminated, color copies of the MAP Tool are available free of charge to healthcare providers, practices, and institutions in New York through the New York State Anticoagulation Coalition and IPRO, the CMS-designated Quality Improvement Organization for New York State.
166.2 KiB251
NDC codes for Oral Anticoagulants obtained from Lexicomp Database, March, 2013
NDC codes for Oral Anticoagulants obtained from Lexicomp Database, March, 2013
310.3 KiB367
Preventing Oral Anticoagulant Adverse Events
This document includes ICD-9 CM codes for conditions that may be indications for oral anticoagulation (e.g. warfarin) and for thrombotic events. This file may be useful to organizations attempting to analyze clinical data and to generate reports on drug utilization and related outcomes.
149.2 KiB290
Preventing Oral Anticoagulant Adverse Events - Data Transfer Protocol
As the CMS-designated Quality Improvement Organization for New York, IPRO is pleased to provide analytic support to evaluate the quality of anticoagulation-related services. To assure that patient data are handled in the most secure and efficient manner possible, we require that the following steps be followed when transferring data to IPRO
180.5 KiB305
Preventing Oral Anticoagulant Adverse Events ICD 9 CM Codes for Bleeding Events
This document contains ICD-9 CM codes for events possibly associated with bleeding events (drug induced or otherwise).
348.4 KiB270
Preventing Oral Anticoagulant Adverse Events SAS™ Program for Formatting ICD 9 Codes Related to Treatment Indications for Warfarin, Bleeding and Thrombotic Events.
This document includes SAS™ programming designed to format and categorize ICD-9 codes associated with indications for oral anticoagulant use (e.g. warfarin) and thrombotic events. This program may be useful to organizations attempting to analyze discharge diagnosis data and to generate reports on related outcomes.
142.4 KiB242
Preventing Oral Anticoagulation Adverse Events SAS Program to Calculate Time in Therapeutic Range (TTR, Rosendaal method)
Preventing Oral Anticoagulant Adverse Events - SAS Program to Calculate Time in Therapeutic Range (TTR, Rosendaal method)
156.0 KiB278

 

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NY State Map & Gold Stamp Program

Care Transitions in the News

At a Glance Newsletter

Volume 2: First Quarter 2016

Volume 3: Second Quarter 2016:

Volume 2 No. 2 – Spring 2016

Volume 1: Fourth Quarter 2015

 

July 2016 State Map

Gold Stamp

Contact Us

New York

Sara Butterfield, Senior Director
518-320-3504
Sara.Butterfield@area-I.hcqis.org

Christine Stegel, Senior Quality Improvement Specialist
518-320-3513
Christine.stegel@area-I.hcqis.org

Fred Ratto Jr., Quality Improvement Specialist
518-320-3506
Fred.ratto@area-I.hcqis.org