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Chronic Disease, COVID-19, Practice Transformation

Advance care planning (ACP) helps ensure patient treatment preferences are documented, regularly updated and respected. This helps make the case that patients are getting what they want at end of life. ACP can start with a conversation and documentation of patient preferences during a Medicare Annual Wellness Visit. This implementation guide breaks down ACP and will help your practice create and refine your processes to support it.


Patient Safety, Population Health, Transitions of Care

As your community comes together to improve transitions and coordination of care, it is important to evaluate the current situation. Seek perspectives from multiple settings. What is working well? Where could improvements be made? Use our Community Assessment Form to guide your discussion.


Long-Term Post-Acute Care, Practice Transformation, Transitions of Care

In collaboration with its Nevada Patient and Family Advisory Council, Comagine Health has created this 8.5"x14" infographic poster or handout that describes Post-Intensive Care Syndrome (PICS).


Long-Term Post-Acute Care, Quality Improvement, Transitions of Care


To improve the clinical outcomes for their patients and based on research that shows admissions from nursing homes are more likely to be for septicemia, hospitals are beginning to partner with LTPACs to improve the early recognition and intervention for signs and symptoms of sepsis. This toolkit is a result of those partnerships developing in Nevada when sepsis coordinators from a hospital system reached out to a small group of nursing homes they receive transfers from to provide education to the clinical staff.