Working Together to Improve Transitions and Reduce Avoidable Readmissions

The Robert Wood Johnson Foundation (RWJF) recognizes and honors efforts to improve care transitions, reduce avoidable hospital readmissions, and lift the overall quality of care. In February 2013, we sponsored the Transitions to Better Care video contest to gather compelling stories of how nurses, care coordinators, physicians and other front-line care team members ensure patients transitioning from the hospital to the home are given and understand comprehensive instructions, and are provided the necessary support and resources to help ensure they remain on a path to wellness.

The entrants might not be Oscar-winning filmmakers (yet), but their passion and commitment to improving patient outcomes shined through in the more than 100 submissions. They provide a glimpse into the types of innovative programs care teams across the country are implementing to help their patients stay well during transitions in care.

We Asked: You Responded!

Screen showing a personalized discharge plan that the patient can access online.

We Asked: You Responded!

Watch the video to learn how communities across America are improving patient care. 

We Asked: You Responded!

Watch the video to learn how communities across America are improving patient care. 

 

Watch the Winning Videos

Queen of the Valley CARE Network

CARE Network

Queen of the Valley CARE Network

Queen of the Valley CARE Network

University of Utah Health Care Transitions

Patient representative works with a doctor to coordinate care.

University of Utah Health Care Transitions

University of Utah Health Care Transitions

 

Our Partners

The Robert Wood Johnson Foundation has convened 25 partner organizations to inform and spread the work being done by providers, patients, and communities to improve care transitions and reduce avoidable readmissions.

About This Initiative

Care About Your Care

This RWJF national initiative focuses on improving care transitions to reduce avoidable hospital readmissions, and how nurses, care coordinators, doctors, consumers, caregivers, patients, and others can work together to achieve this.

Learn more