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Health Care Reform

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Access to Services | Care Transitions | Care Transitions Conferences |
Evidence-based Programs and Services | Hot Spots | Medicare/Medicaid
Self-Management Plans (Flags) | Tools for Patient Engagement | Other Resources

Better Care, Lower Costs

Accountability, patient safety, and reduction of unnecessary hospital readmissions are high priorities of the health care reform movement. Across the nation, communities are organizing to provide better health care for Medicaid and Medicare beneficiaries—and others—at significantly lower cost by coordinating care among providers and improving the management of the chronic conditions that often lead to hospitalization.

Area Agencies on Aging and their network of health and social service providers bring new opportunities for health reform savings and service delivery improvements.

Aging and Disability Services AAA Seattle King County care transitions brochureCare Transitions

Aging and Disability Services (ADS) is committed to reducing unnecessary readmissions at local hospitals. We collaborate with health care providers to enable more effective transitions from hospital to home. We coach patients and their caregivers to follow their physicians’ discharge orders and manage their health care more effectively. Following are a variety of resources for local hospitals:

Self-Management Plans (Flags)

ADS has collaborated with hospitals to determine chronic conditions prevalent in south King County and to develop patient education materials for those conditions, plus several others.

Following is a series of Self-Management Plan handouts that include warning flags (green flags to indicate health, yellow flags that indicate warnings, and red flags that indicate emergencies) and Personal Health Records that help patients track providers, medications, and questions for their health care team:

Some translations are also available. Each of these Self-Management Plans can be printed on 11x17 paper. They are available for use by any organization by request and may be modified, adapted, or built upon for publication if credit is given to Aging and Disability Services. Feedback is appreciated. Special thanks to Highline Medical Center, Northwest Kidney Centers, Valley Medical Center, and Washington Dental Service Foundation for input.

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Access to Services

Our booklet “Aging Network Services for King County Residents” is a handy guide to programs and services discharged patients may need, including referral for Medicaid long-term services and supports.

Evidence-based Programs and Services

Tools for Patient Engagement

Aging and Disability Services RNs, social workers, and care transitions coaches are trained to use specific strategies for patient engagement:

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Care Transitions Conferences

2014 Conference

Upcoming Conference: Care Transitions: Continuing the Conversation is a conference on Thursday, October 2, in Des Moines, WA. For registration and other information, visit www.agingkingcounty.org/CTconference. For information on previous conferences, see below.

Listserv: To ensure that you receive timely notice of upcoming conferences, subscribe to the South King County Care Transitions Listserv (open to anyone interested in improving health care quality and transitions of patients among care settings, regardless of geographic region).

Past Conferences

Aging and Disability Services has coordinated annual conferences related to health care quality since 2011. Summary information is available below.

Care Transitions: What Does It Really Look Like? report June 5, 20142014 Care Transitions: What Does It Really Look Like?
2013 Care Transitions: Whose Job Is It Anyway? conference report2013 Care Transitions: Whose Job Is It Anyway?
2012 Care Transitions Community Meeting South King County conference2012 Care Transitions Community Meeting
2011 Focus on the Future Forum
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The Kent Fire Department's program, FDCARES, demonstrates the important role that emergency responders can play in reducing unnecessary re-hospitalizations. For more information, visit www.FDCARES.com.

Medicare/Medicaid

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Hot Spots

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Other Resources:

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Consumers

Advisory Council

AAA Staff

Service Providers

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