Goal:
Care coordination as part of Health Care Homes is a focus of ambulatory care redesign for patients with chronic care needs, with self-management support as an integral component. According to the Chronic Care Model, successful self-management support involves effective partnerships with community service organizations. The purpose of this webinar is to examine those partnerships.

Objectives

Examine a model to enhance care coordination and self-management support within the Health Care Home through partnerships with community service providers, patients/families, and NCCs using Community Connections, a Community Care Team intervention.
Discuss using the strengths-based Wraparound Process adapted for use with older adults as a way to develop informal Circles of Support.
Evaluate the effect of the community care team intervention on patient outcomes and use of services.

Requirements for Successful Completion: Complete the learning activity in its entirety and complete the online CNE evaluation.

Faculty, Planners and Authors Conflict of Interest Disclosure: Speakers have no disclosures to declare.

Resolution of Conflict of Interest: The resolutions of conflicts of interest are completed during the planning process. It is the responsibility of the nurse planner to identify and resolve any conflicts prior to implementation of the learning activity. When a conflict of interest is noted during the planning process, the nurse planner will actively involve the speaker, presenter or author in the resolution of the identified conflict of interest. The resolution process for a conflict of interest will be documented in the activity file. The potential conflict of interest will be outlined to the planner/presenter/author on the Disclosure Form. The purpose of the disclosure is not to prevent a presenter/ content expert from presenting, but rather to provide the learners with information from which they may make their own decisions. Relevant relationships or potential COI will be identified to learners through a disclosure process.

Commercial Support and Sponsorship: No commercial support or sponsorship declared.

Non-Endorsement of Products: Accreditation of activity for contact hours does not imply approval or endorsement of any product, advertising, or educational content by Anthony J. Jannetti, AAACN , or the American Nurses Credentialing Center’s Commission on Accreditation.

Accreditation Statement: This educational activity has been co-provided by Anthony J. Jannetti, Inc. and AAACN. Anthony J. Jannetti, Inc. is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. Accreditation status does not imply endorsement by the provider or ANCC of any commercial product. AAACN is a provider approved by the California Board of Registered Nursing, provider number CEP 5366.

Diane Elizabeth Holland PhD, RN

Appearances