Mayo post acute care program and care continuum

Abstract

The Mayo Post Acute Care Program highlights the opportunity for healthcare organizations to establish high quality post acute care pathways to match the demands in acute care hospitals. Key elements of the program include teamwork, staff empowerment, collaboration across care settings, and development of new pathways outside the hospital. The program eliminates the notion of discharge, and promotes high-quality programs, transitional and ventilator care as patients are most vulnerable as they transition from one setting to the next. Team centric processes, establishing key metrics, reliably implementing evidence based care are all important strategies for optimizing care across the continuum. There are also significant opportunities to apply improvement methods to maximize compliance of evidence based care in the ambulatory care setting as well which could have significant positive impact on reducing flow into the hospital.