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Michigan Transitions of Care Collaborative (M-TC2)

A description of the main goals of the initiative:

Statewide quality collaborative designed to address improved care transitions from hospital to home (or next site of care). 

A brief discussion of the scope of the project, and the interventions and metrics, if appropriate:

The project provides physician organization/hospital teams with a mentored implementation program with mentors from across the state of Michigan.  The Society of Hospital Medicine’s Project BOOST resources are made available to all of the teams to utilize or modify as they see fit for their organizational needs.  Basic metrics such as readmission rates for the hospital and specific intervention unit(s), number of discharge summaries received by the next caregiver within 72 hours of discharge, and # of follow-up appointments within 7 days of discharge are tracked.

Participants: Scott Flanders



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