New Jersey Health Initiatives - A Better State of Health
A Robert Wood Johnson Foundation Program
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NJHI: 2011: Transitions in Care

This initiative supported projects that implemented systems and methods to manage and promote effective transitions in care for adult patients with multiple chronic health conditions and complex social circumstances.

Projects

Implementing systems to manage transitions in care and reduce hospital readmissions.

Camden Coalition of Healthcare Providers – Improving Care Transitions for High Needs, High Cost Patients in Camden

Cooper Foundation

Implementing systems to manage transitions in care and reduce hospital readmissions.

CARE – Collaborative Approach to Reach Patient Empowerment

Community VNA

Implementing systems to manage transitions in care and reduce hospital readmissions.

Community Hospital-Based Integrated Delivery System, Centered Around Patient Transition of Care

Underwood-Memorial Hospital

Implementing systems to manage transitions in care and reduce hospital readmissions.

I-Care 4 Health Transitions: Improving Care for a Health Transition using a 4-Tiered Approach to Collaboration Across the Continuum

Foundation of University of Medicine & Dentistry of New Jersey

Implementing systems to manage transitions in care and reduce hospital readmissions.

Improving the Health Care Transition Process for Persons with Developmental Disabilities & Medically Complex Conditions

Matheny Medical & Educational Center

Implementing systems to manage transitions in care and reduce hospital readmissions.

Partnership for PIECE (Patient-Centered Integrated Elder Care and Empowerment)

Princeton HealthCare System
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