- Mental Health and Well-Being Digital Toolkit
- Upstate Works Staffing Agency
- Collaborative Models of Community Medicine and Paramedicine
- IHA-AHP Recruitment and Retention Strategies for Healthcare Leadership Series
- Hospital-Home Care Collaboration
- “Take A Look” Virtual Job Fairs
- “Take A Look” Upstate NY In-Person Tours
The purpose of this program is to improve hospital-home care synchronization for front-end/pre-acute hospital care as well as far-end/post-hospital care, recovery, and long term support.
As part of this effort, IHA, HCA, E&R, and HANYS have curated and hosted a series of webinars featuring prototypes of hospital and home care collaboration models that can be emulated by other providers statewide — working together, across settings.
This initiative also includes a library of online resources and tools to assist hospital-home care collaborative development, provide technical assistance, and further education on identified collaboration needs and issues.
Together these efforts ensure that patients do not end up admitted or readmitted to the hospital unnecessarily, so that hospitals can dedicate resources where they are most needed for emergency, critical, surgical, trauma and/or other specialty care.
This is especially important during medical surges, like in the COVID-19 pandemic, which has placed enormous stresses on hospital capacity, further necessitating strong mutual support partnerships across settings.
NEW YORK STATE HOSPITAL-HOME CARE COLLABORATION MODEL REPORTS
Over the past three years, our Collaborative has promoted and supported replication of prototype models of collaboration through presentations, education and technical assistance to hospitals, home care providers , physicians, health plans, mental health and other core partners statewide. In the last quarter of 2022, we developed four reports to assist the statewide healthcare community in ongoing health, mental health and aging services collaboration.
- Two Innovative Models Address Healthcare Workforce Challenges – two-page summary and full powerpoint
- Compendium of Statewide Hospital-Home Care Collaborative Models ─ features prototypes of hospital-home care-physician collaboration models that offer transformative designs and major pre- and post-acute impacts. These models were featured in our statewide presentations and educational efforts.
- Innovative Health-Mental Health Collaboration Models: A Primer ─ focuses on collaborative hospital-home care-mental/behavioral health models that foster interdisciplinary collaboration, prevent/better manage emergencies and avoid hospitalization and long-term institutionalization. This primer also profiles OMH supportive housing programs that help people with behavioral health needs who are entering the community or aging in place to be successful in the integrated settings.
- Hospital and Home Care Partnerships with Aging Providers: Collaboration Models and Lessons Learned ─ HCA, HANYS and IHA collaborated with the Association on Aging in New York and several county offices for the aging to identify prototypes for hospital, home care and aging services collaboration. Programs highlighted in this report show how to improve aging in place and how to enhance older adults’ health through community-based aging services and healthcare integration. The highlighted models demonstrate that successful hospital, home care and aging services collaborations are multifaceted and provide a foundation for future collaborative work.
- Collaborative Prototypes & Lessons Learned During the COVID-19 Vaccine Rollout ─ presents community collaboration models achieved by hospitals, home care and community partners in responding to the COVID-19 vaccination imperative. Regional vaccination hub leaders were invited to share major takeaways from these collaborations and to offer insights on other major healthcare delivery and public health goals beyond COVID-19 to which these lessons and practices could be applied.
NEW YORK STATE HOSPITAL-HOME CARE COLLABORATION MODEL HIGHLIGHT VIDEOS
When hospitals partner with home health care providers to find new solutions to long-standing obstacles, patients recover more quickly and they do it at home– right where they want to be. Learn how these organizations came together & transformed patient care! Read the press release here.
St. Peter’s Health Partners
New York-Presbyterian Queens & St. Mary’s Home
University of Rochester Medical Center & UR Home Care
STATEWIDE VIRTUAL WORKFORCE SUMMIT
Hosted on May 26, 2022
Hosted on December 2, 2021
Registered attendees will need to use their login credentials to access recordings. If you did not attend the Summit or previously register, you can do so at the link to gain access to all recordings.
WEBINARS & RELATED RESOURCES
- Ambulatory Management of Moderate to High Risk COVID-19 Patients: The Coronavirus Related Outpatient Work Navigators (CROWN) Protocol. Home Health Care Management and Practice. October 2020.
WATCH Webinar: High Risk/High Need Patient Collaborative | Nathan Littauer Hospital, Community Health Care Center of St. Mary’s and Nathan Littauer Hospital
WATCH Webinar: Critical Illness Recovery Program | University of Rochester Medical Center, URMC Home Care
WATCH Webinar: eMOLST Physician-Hospital-Home Care Collaborative | Dr. Patricia Bomba, NYU Hospital, Visiting Nurse Service of New York | Related Resources:
- Video: Thoughtful MOLST Discussions in Hospital & Hospice Settings. CompassionAndSupport.org.
- Video: Thoughtful MOLST Discussions in the Nursing Home Setting. CompassionAndSupport.org.
- MOLST Form and related resources. MOLST.org.
- MOLST General Instructions for Adults. New York State Department of Health.
- 8-Step MOLST Protocol. MOLST.org.
WATCH Webinar: Integrated Care and Care Management Collaborative | Gurwin Health Care System, Stony Brook Hospital, Stony Brook Physician Practice
WATCH Webinar: Pre-acute/Post-acute Collaborative | Mount Sinai South Nassau, South Nassau Home Care
WATCH Webinar: Population Health Collaborative and Analytics Partnership | Upstate Medical Center, Nascentia Health, Upstate Home Care
WATCH Webinar: Utilizing Strategic Design to Foster Homecare-Hospital Collaboration Initiatives | M.S. Hall & Associates
GENERAL COLLABORATION RESOURCES
- 5 ways Hospitals Can Boost Capacity Through Home Health. Advisory Board. 2020.
- Impact of Home Health Care on Health Care Resource Utilization Following Hospital Discharge: A Cohort Study. American Journal of Medicine. 2017.
- Innovative Home Care Models: Five Profiles in Cost Savings, Care Transitions. Simione Healthcare Consultants. 2012.
- Trends and Insights to Collaborate with Physicians, Care Teams, Patients and Family Members. Remington Report. 2021.
- Health Careers Information. Center for Health Workforce Studies. 2022. This website serves as a guide for anyone interested in a career in health care.
- Hospital-at-Home. American Hospital Association. 2022. Explore AHA’s growing repository of resources on hospital-at-home, including case studies and podcasts.
CLINICAL AREAS FOR COLLABORATION
- Stop Sepsis at Home NY Screening Tool. Home Care Association of New York State.
- Sepsis in Home Health Care. October 2020. Journal of Nursing Care Quality.
- Does Early Follow-Up Improve the Outcomes of Sepsis Survivors Discharged to Home Health Care? August 2020. Medical Care – Journal of the American Public Health Association.
- GoldSTAMP Collaboration Program to Reduce Pressure Ulcers. State University of New York at Albany School of Public Health.
LAWS, POLICIES GOVERNING COLLABORATION
- Public Health Law Section 2805-x: the Hospital-Home Care-Physician Collaboration Law.
- 2805-x Implementation Guidance from the New York State Department of Health.
- Statewide Health Care Facility Transformation Program III – NYS DOH, Applications must be submitted in Grants Gateway by 4:00 PM EST on Wednesday, January 12, 2022.
TELEHEALTH & COLLABORATION
PERSON-CENTERED CARE FOR COLLABORATION
- 8 Step Change Process for Improving Transitions of Care. Planetree.
- Person-Centered Guidelines for Preserving Family Presence in Challenging Times. Planetree.
- Age Friendly Health Systems. Institute for Healthcare Improvement.
- New York State Action Community. HANYS.