The health care experience is taxing and confusing for patients and their families. The complexity often leads to disengagement and poor adherence to the plan of care. The Bridge Model is designed to integrate into any health care system in order to address these issues.
Bridge uses social workers to provide transitional care services, and leverages psychotherapy techniques to increase patient activation and follow-through. This approach of addressing both medical and social issues leads to many positive outcomes, including significantly lower readmission rates and decreased stress for patients and family caregivers.
The overarching mission of the CATCH-ON is to unify state-wide academic, health, and community organizations and resources to prepare a geriatric collaborative practice-ready health workforce optimizing health while, serving and improving patient-centered health and wellness outcomes. CATCH-ON collaborators and partners, in consultation with the Health Resources and Services Administration (HRSA), older adults, family caregivers, and […]
Analysis of a Social Work–Based Model of Transitional Care to Reduce Hospital Readmissions: Preliminary Data by Boutwell and colleagues was published in the Journal of the American Geriatrics Society (May 2016). Findings demonstrated all cause readmissions among all home-going Medicare FFS beneficiaries by a statically significant 20%. This effort was conducted at scale – 1,546 discharges to home (with or without home […]