Project Term: 12 months; 2017-2018
Grant Amount: $44,236
The goal of this project is to develop a new approach to discharge planning for hospitalized patients that systematically identifies and addresses the social factors that influence outcomes, such as the ability to afford home heating, food, housing, and medications. The Cabinet Peaks Medical Center will develop a discharge planning tool that identifies these needs and works with local clinics, aid, and social service agencies to provide a safety net of services for patients at the time of discharge. The project seeks to reduce re-admissions related to socioeconomic barriers to health and to increase the acuity of patients seen in the emergency department as well as utilization of local clinics for outpatient care.