title: Case managers: a key to reducing readmissions.
authors.affiliation: Jennifer L. Ellsworth, MSW, is a clinical social worker within the palliative care team at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire. Throughout her social work career, she has focused on the geriatric population, transitions of care, and community support. Before her position at Dartmouth-Hitchcock Medical Center, she developed and implemented a $3.2-million CMS Care Transitions Grant that funded a hospital-wide transitions of care program. Jennifer's contribution to this column reminds us of how we manage and support our patients individually while focusing on "key indicators," such as readmissions.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Ellsworth
mesh_terms: D019090:Case Management / Q000458:organization & administration*; D006801:Humans; D007400:Interprofessional Relations; D006278:Medicare; D010351:Patient Discharge; D010359:Patient Readmission / Q000706:statistics & numerical data* / Q000639:trends; D010360:Patient Transfer / Q000592:standards*; D058996:Quality Improvement; D014481:United States