Promoting Care Coordination Through CHART
October 26, 2015 - Lawrence General Hospital is pleased to announce the launch of the Community Hospital Acceleration, Revitalization and Transformation (CHART) Program as of October 1, 2015. CHART is a two year grant funded program awarded by the Health Policy Commission designed to promote care coordination between hospitals and community-based providers and organizations.
The CHART program encourages enabling technologies to provide better communication and care across the continuum. The CHART Program is focused on providing care coordination to our socially and medically complex patients to reduce readmissions by 20%. Patients are identified as socially complex through risk assessments, readmission assessments, and provider referrals. Patients enrolled into the program will receive outpatient care coordination 90-days post discharge by one of our two social workers and a registered nurse.
The CHART Team is working in collaboration with our community partners at Elder Services, Home Health VNA, and Lahey Health Behavioral Services to provide the best transitional support services that the Merrimack Valley has to offer. The program is designed to work with our community partners to create personalized care plans that are focused on meeting the patient’s goals to keep them healthy during their transition from the hospital to their home.