Transitional Care Pilot Project
Critical Care Nursing | Medicine and Health Sciences | Nursing
The original grant was for a Transitional Care Pilot Project that would have allowed our students to be involved in the Care Transitions Innovation (C-TraIn) program in the fall of 2014. This grant focused on identifying high emergency room users and patients with multiple hospital admission rates. Originally, patients were to be identified by hospital case managers and they were slated to work with our students. After receiving the Faculty Development Grant, Legacy Good Samaritan Hospital announced they were no longer going to be involved with the C-TraIn program. However, after negotiating with various hospital administrators, I was able to convince them to allow us to work with one of their primary care clinics instead and allow our students to make home visits. These home visits target patients of a primary care clinic instead of patients identified by hospital-based case managers. After several meetings and negotiations in the fall of 2015, we were finally allowed to have eight nursing students in one of Legacy Health’s primary care clinics work with primary care providers and a nurse manager who was hired specifically to work with their high-risk clients.
Webb, Jackie F., "Transitional Care Pilot Project" (2016). Post-Grant Reports. Report. Submission 80.