Reducing Avoidable Rehospitalizations: Getting Started with Creating an Ideal Transition from Hospital to Home

​This video from the Institute for Healthcare Improvement presents key design elements to help organizations and communities get started with creating an ideal transition home for patients being discharged from the hospital and their families, as part of overall efforts to reduce avoidable rehospitalizations.


Gail Nielsen, Director of Learning and Innovation at Iowa Health System, and Peg Bradke, Director of Heart Care Services at St. Luke’s Hospital in Iowa, discuss the key design elements for engaging in this work.


After viewing this video, participants will be able to:

  • Describe the role of the Executive Sponsor
  • Identify strategies to establish cross-continuum collaboration
  • Describe methodologies for identifying opportunities for improvement from the diagnostic review
  • Develop an aim statement


This video is a filmed presentation from the IHI seminar Reducing Avoidable Readmissions by Improving Transitions in Care.


Getting Started: Creating an Ideal Transition from Hospital to Home
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