Albuquerque Transitions of Care
Community Collaborative 

Register for the Albuquerque Transitions of Care Community Collaborative meeting. This meeting is an opportunity for hospitals, long-termed facilities, primary care providers, home health, and community organizations engage and share best practices to improve patient care coordination.

Intended audience:

• Hospital leadership (case/care management staff, quality teams)
• Skilled Nursing Facility Leadership (medical directors, administrators, directors of nursing)
• Primary Care Physician offices, Home health agencies, and other community partners 

Goal and objectives:

To provide an opportunity for hospitals, long-termed facilities, primary care providers, home health, and community organizations engage and share best practices to improve patient care coordination.

The collaborative will:

1. Identify and discuss current transitions of care/coordination efforts of member organizations
2. Identify additional resources that support transitions of care
3. Define actions needed to advance community-wide care transitions initiative
4. Determine calendar schedule for 2015-16 meeting dates
5. Identify ‘next steps’ for group collaborative