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  1. Nurse health coaches (NHCs) may be one way we can help pa-tients adopt lifestyle changes and prevent revolving-door admissions. What is an NHC? NHCs are taught to keep an open mind, focus on what patients per-ceive to be barriers to a desired goal, and help them recognize their strengths.

  2. Oct 21, 2014 · Discharge planning and involvement of a home-care transition coach — either a nurse or social worker — has been shown to facilitate implementation of the patient’s recovery goals in the community and reduce the risk of recurrent admissions, as well as being cost-effective compared with usual care.8 Disappointingly, the interventions ...

    • Cara Tannenbaum
    • 2014
  3. Sep 26, 2022 · This highlights the importance of strategies that include housing stability to reduce revolving door in the HP. A network-based concept integrates different health care specialists. This includes psychiatrists, specialized nursing staff and psychologists, social workers and pedagogues.

  4. Session Objectives. Understand the benefits from hospital and primary care perspectives of working together to address hospital readmissions versus working in silos. Explain how care transitions impact avoidable and unavoidable readmissions for populations at risk. Understand why COPD /CHF populations were targeted.

    • Coaching Interventions
    • Number of Coaches
    • Length of Intervention
    • Duration of Each Coaching Session
    • Preparation of Coaches

    Following section summarized the findings in relation to the types of coaching interventions used for health coaching (Table 3).

    The number of coaches used is important for quality assurance of the coaching intervention. The number of coaches involved in each study varied between studies. Of 17 articles included, there were three articles [34, 40, 43] which did not specify the number of coaches that were involved. Of those studies which stated number of coaches (14 studies),...

    The length of intervention varied from one week for post-surgery to 18 months for chronic illness management. The average duration of intervention across the studies was eight months. Number of coaching sessions offered varied from three to 12 sessions with average of seven coaching sessions provided throughout the duration of the coaching interven...

    The duration of each coaching session varied between studies, with a minimum of ten-minutes to the maximum of 120-minutes. Of 17 studies, four studies [34, 37, 39, 44] did not report the duration of each session. In all the studies, which specified the duration of their coaching sessions, first coaching session are likely to be longer in comparison...

    Education and training of nurses prior to coaching was seen as a variable that may explain why some studies showed or did not show efficiency for coaching to improve the chronic conditions. Coaching is not a regulated practice at this point of time and therefore coaching generally has a range of education and training courses, with many not providi...

    • Jennieffer Barr, Lily Pei-San Tsai
    • 2021
  5. Through efficient coordination, communication, planning, and ed-ucation, nurses and nurse case managers (NCMs) can play a piv-otal role in reducing readmissions. Starting at admission, we can miti-gate readmission risk at multiple points during the predischarge and postdischarge periods by:

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  7. May 11, 2015 · Hospital readmissions are costly to patients and healthcare facilities. Nurses and NCMs are natural communicators and educators, putting them in an excellent position to help prevent readmissions at multiple points—from admission through discharge and beyond.

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