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Community Health Needs Assessment Toolkit
The Association for Community Health Improvement’s Community Health Assessment (CHA) Toolkit offers a nine-step pathway for conducting a CHA and developing implementation strategies. Click on the icon for each step to read about that part of the process.
Web link    Date Added: 08/09/2020    Date Last Modified: Aug 6 2020 5:48PM  
EQIC Preventable Readmissions
Beginning in 2020 as a part of the Centers for Medicare & Medicaid Services (CMS) Hospital Quality Improvement Contract (HQIC), the Eastern US Quality Improvement Collaborative (EQIC) initiative supports participating hospitals' improvement work with education, tools, resources and direct project management support. This EQIC pages offers information, tools, resources, webinars and focus areas targeting preventable hospital readmissions.
Web link    Date Added: 03/17/2023    Date Last Modified: Mar 20 2023 3:27PM  
Healthy Community Design Checklist Toolkit
This toolkit from the Centers for Disease Control and Prevention can help planners, public health professionals, and the general public include health in the community planning process. Developed in partnership between the American Planning Association’s Planning and Community Health Research Center and the Centers for Disease Control and Prevention’s Healthy Community Design Initiative.
Web link    Date Added: 08/09/2020    Date Last Modified: Aug 6 2020 5:45PM  
Hospital Follow-up Appointment Postcards
This package includes a postcard in both English and Spanish to give to patients after hospitalization to schedule future appointments. The package also includes instructions for providers to effectively use the postcard.
ZIP archive    Date Added: 11/09/2016    Date Last Modified: Mar 24 2022 11:46AM  
Improve the Quality of Care Transitions Change Package
The TMF Quality Innovation Network, under contract with the Centers for Medicare & Medicaid Services, designed this change package to provide strategies to improve the quality of care transitions.
Adobe PDF    Date Added: 01/17/2023    Date Last Modified: Jan 17 2023 6:13AM  
Increase Patient Safety, Infection Prevention and Control in the Community Change Package
The TMF Quality Innovation Network developed this document to assist health care professionals to increase patient safety by reducing C. diff rates and improving antibiotic stewardship in health care facilities serving high-risk fee-for-service Medicare beneficiaries.
Adobe PDF    Date Added: 05/26/2020    Date Last Modified: Dec 18 2020 1:06PM  
Integrating Behavioral Health Across the Continuum of Care
One in four Americans experiences a behavioral health illness or substance abuse disorder annually, and the majority of these people have comorbid physical health conditions. This guide explains the value of integrating physician and behavioral health services and the importance of measuring these efforts.
Web link    Date Added: 03/20/2014    Date Last Modified: Dec 18 2020 1:08PM  
Nurse-to-Nurse Hand off/Transfer Report (One Page)
When transferring a patient, this checklist can be used between a patient’s current and receiving caregiver.
Adobe PDF    Date Added: 02/24/2020    Date Last Modified: Aug 24 2020 1:06PM  
Nurse-to-Nurse Hand off/Transfer Report (Two Pages)
When transferring a patient, this checklist can be used between a patient’s current and receiving caregiver.
Adobe PDF    Date Added: 02/24/2020    Date Last Modified: Aug 24 2020 1:06PM  
Patient Self-Care Workbook: Diabetes
This workbook is designed to help patients with diabetes better manage their condition. Patients can take this workbook with them to their doctor's appointments and use it to help guide a conversation with their physician(s) to learn how to better manage their condition and over health.
Adobe PDF    Date Added: 01/23/2015    Date Last Modified: Dec 18 2020 2:28PM  
Podcast: Multimodial Pain Intervention
Listen to this podcast with Clifford Moy, MD, the behavioral health medical director at TMF Health Quality Institute and Dr. Paul Milligan, a clinical pharmacist, as they discuss multimodal pain management.
Podcast    Date Added: 08/26/2020    Date Last Modified: Mar 24 2022 5:42PM  
Podcast: Opioid Induced Respiratory Depression
Listen to this podcast with Clifford Moy, MD, the behavioral health medical director at TMF Health Quality Institute and Dr. Paul Milligan, a clinical pharmacist, as they discuss opioid-induced respiratory depression.
Podcast    Date Added: 08/26/2020    Date Last Modified: Mar 24 2022 10:00PM  
Podcast: Opioid Safety in Nursing Home Residents
Listen to this podcast with Clifford Moy, MD, the behavioral health medical director at TMF Health Quality Institute and Dr. Paul Milligan, a clinical pharmacist, as they discuss discuss opioid safety in nursing home residents.
Podcast    Date Added: 08/26/2020    Date Last Modified: Mar 24 2022 10:01PM  
Quality Improvement Workbook
Use this workbook to begin identifying an area for improvement and developing a team to address the improvement.
Adobe PDF    Date Added: 10/06/2016    Date Last Modified: Dec 18 2020 2:43PM  
Social determinants of health are a factor in 30-day readmission rates, study finds
This study examined whether socio-demographic and -economic factors influence 30-day readmissions for conditions such as chronic obstructive pulmonary disease, pneumonia, acute myocardial infarction and heart failure.
Web link    Date Added: 03/18/2024    Date Last Modified: Mar 25 2024 8:22AM  
Transitional Care Model
Learn about the Transitional Care Model, a nursing-led program pioneered at The University of Pennsylvania, with a focus on improving the health outcomes of older adults with complex health care needs while efficiently using resources and reducing costs.
Web link    Date Added: 08/06/2020    Date Last Modified: Aug 6 2020 5:37PM  
Teach-Back Nurse Practice Exercise (Spanish for Puerto Rico)
This handout provides nurses a step-by-step guide on how to teach congestive heart failure patients to take certain medications. This document is in Spanish suitable for a Puerto Rican audience.
Adobe PDF    Date Added: 05/24/2016    Date Last Modified: Mar 23 2022 1:02PM