The IHI Triple Aim is a framework developed by the Institute for Healthcare Improvement that describes an approach to optimizing health system performance.

Guided Care® helps primary care practices meet the complex needs of patients with multiple chronic conditions. In this proven care model, a trained Guided Care nurse works closely with patients, physicians and others to provide coordinated, patient-centered care.

Under the direction of Eric A. Coleman, MD, MPH, the Care Transitions Program® will help you manage risk and empower patients during care hand-overs.

AAACN has developed a number of resources focused on CCTM; including the CCTM Model, CCTM Core Curriculum, and CCTM online modules.

This report is the third in a series of ANA policy documents addressing care coordination and it presents the Framework by explaining its origin, detailing its component parts, and illustrating how it combines to inform quality measurement and improve care within the broader health care environment. The report’s supplements are intended to provide additional information and a summary of the supporting evidence base.

As recent studies suggest, professional nurses have the potential for significant contributions to patient-centered, cost-effective care through the care coordination role. In order to fully achieve this potential, clear models and outcome measures are needed which specify the context for care coordination, identify nursing competencies, and value the nurse’s role within the health care team.

This article explores the individual and collective contributions of registered nurses in ambulatory care and the value of the impact of those contributions on patient outcomes.

This clinical practice guideline (CPG) has been developed under a project conducted by the American Medical Directors Association (AMDA), and is intended for the members of the interdisciplinary team in long-term care facilities, including the medical director, director of nursing, practitioners, nursing staff, consultant pharmacist, and other professionals such as therapists, social workers, dietitians, and nursing assistants who care for residents of long-term care facilities.

This document provides an overview of the pediatric care coordination curriculum developed by Dr. Peter Antonelli, and provides information on contacting him for access to the full content.

A sample tool for assessing the care coordination process for pediatric patients in a hospital environment.