Common use of Project Goal Clause in Contracts

Project Goal. Comprehensive discharge processes -- wherein the patient and the hospital share an understanding of care and follow up plans -- are critical to successful implementation of accountable care models. To prepare in this regard, hospitals may need to refine, and in some cases re-engineer, their existing discharge processes to reduce unnecessary readmissions, increase adherence to follow up care recommendations and thrive under alternatives to fee-for-service payments. Projects will focus on standardizing and personalizing the complex hospital discharge process to reduce unnecessary readmissions and improve quality, thereby better positioning the hospital system for success in a global payment environment. The project may be specifically tailored to address the unique challenges disadvantaged populations have as they change care settings and improve both medical, patient experience, and utilization outcomes. It may also use an interdisciplinary approach of case managers, pharmacists, social workers, and patient navigators will work together to deliver customized transition support specifically addressing the medical, psychological and social needs of disadvantaged patients. Potential Project Elements DSTI hospitals undertaking this project may select from among the following project elements: Structural Process