Addressing the Pain Points
Identifying interventions to address goals for cost and quality is a first step – it’s a plan. TEAM-Win contains a TEAM-Playbook with dozens of best-practice processes. These processes (or Care Coordination Programs) are sets of specific interventions proven to systematically reduce costs and improve quality of care across a clinically integrated network. Each TEAM-Playbook is customized to connect your data systems and distribute work to your TEAMs.
Playbooks are Pre-Built Best Practices
Take a look at the list of pain points below – and the multiple TEAM-Playbooks that can help your organization achieve exceptional results.
Some of the Playbooks that help reduce hospital admissions:
- High-Risk Patient Management
- Chronic Condition Management
- Closed-Loop Referral
- Annual Wellness Visit Program
- Encounter Notification Response
- Post-Discharge Management
- Post-Acute Facility Integration
- Patient Goal Management
Some of the Playbooks that help reduce ED Utilization:
- High-Risk Patient Management
- Chronic Condition Management
- Closed-Loop Referral
- Annual Wellness Visit Program
- Encounter Notification Response
- Post-Discharge Management
- Post-Acute Facility Integration
- Patient Goal Management
- Preventative Health Integration
Some of the Playbooks that help reduce costs and improve care through better Chronic Disease Management:
- Condition Program Enrollment
- At-Risk Population Registry
- At-Risk Population Intervention
- Condition-Specific Key Success Factor
- Closed-Loop Referral
- Self-Management Evaluation
- Deterioration Response Protocol
- Patient Goal Management
Some of the Playbooks that help reduce costs and improve care through better Post-Acute Facility Integration:
- Service Selection Program
- Site Selection Program
- Integrated Care Planning
- Integrated Discharge Planning
- Deterioration Response Protocol
- Closed-Loop Communication
- Post-Discharge Management
Some of the Playbooks that help Reduce Network Leakage:
- Condition Program Enrollment
- Encounter Notification Response
- Discharge Planning
- Transfer Facilitation
- Closed-Loop Referral
- Post-Discharge Management
- Post-Acute Facility Integration
Some of the Playbooks that help improve Quality Measure Performance:
- Preventative Health Integration
- Chronic Disease Management
- Integrated Care Planning
- Integrated Discharge Planning
- Deterioration Response Protocol
- Closed-Loop Communication
TEAM of Care works with you to design and deploy workflows to address your most pressing needs. Operational efficiency is the opposite of “burnout.” Operational performance that reduces waste increases margins that are straining hospitals and health systems. Value-Based Care contracts that depend on TEAM-Work and TEAM-Management – from preventative care, to chronic condition management, to hospitalization, through post-acute recovery, all benefit from better task distribution and follow-up.