Using a Mortality Risk Predictor Model for Advance Care Planning via a Transitions of Care Toolkit
Identify high risk mortality inpatients to provide them with a Transition of Care Toolkit to help with advance care planning.
Transitional Care Settings
Development and Implementation of a Hospital at Home Program in Wake County
A Hospital at Home program in Wake County that would allow patients to be treated for hospital-level conditions in their homes.
Improving racial disparities in unmet palliative care needs among ICU family members
Systematically engaging families and helps ICU clinicians deliver needs-targeted palliative care.
Pallialytics: Using analytics to inform a palliative care population health management intervention
A viable predictive model to positively affect patient palliative care workflows.
A Three-Pronged Approach to Reducing HIV Transmission through Pre-Exposure Prophylaxis (PrEP)
Development of a three-pronged program to decrease HIV transmission and increase awareness in the Duke and Durham community, including the creation of a dedicated Duke PrEP clinic at Duke Medical center, educational promotion, and community outreach.
Mobile Complex Care Plans for Children with Medical Complexity
Implementing a mobile complex care plan for provider and patient’s guardians to coordinate care approaches.
Use of telehealth video conferencing to improve the hospital to SNF care transition
Novel use of telemedicine to facilitate weekly post-discharge care conferences between hospital and skilled nursing facility provider teams to systematically review patients, improve transitional care and reduce readmissions.