title: Mr. G And The Revolving Door: Breaking The Readmission Cycle At A Safety-Net Hospital.
abstract: A patient with complex needs returns to the hospital again and again, despite his care team's efforts to reduce readmissions.
authors.affiliation: Carolyn Dickens is a nurse practitioner managing heart failure patients and director of the University of Illinois at Chicago program targeted at Reducing Unwanted Heart Failure Readmissions (RUHFR). Denise Weitzel is a clinical social worker with the EPiC Team, a multidisciplinary consultation service that identifies and manages health care superutilizers, at the University of Illinois at Chicago. Stephen Brown (sbbrown9@uic.edu) is director of preventive emergency medicine at the University of Illinois at Chicago and project leader for the EPiC team. The patient's name and certain identifying details were changed to protect his family's privacy.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Dickens
authors.affiliation: Carolyn Dickens is a nurse practitioner managing heart failure patients and director of the University of Illinois at Chicago program targeted at Reducing Unwanted Heart Failure Readmissions (RUHFR). Denise Weitzel is a clinical social worker with the EPiC Team, a multidisciplinary consultation service that identifies and manages health care superutilizers, at the University of Illinois at Chicago. Stephen Brown (sbbrown9@uic.edu) is director of preventive emergency medicine at the University of Illinois at Chicago and project leader for the EPiC team. The patient's name and certain identifying details were changed to protect his family's privacy.
authors.forename: Denise
authors.initials: D
authors.lastname: Weitzel
authors.affiliation: Carolyn Dickens is a nurse practitioner managing heart failure patients and director of the University of Illinois at Chicago program targeted at Reducing Unwanted Heart Failure Readmissions (RUHFR). Denise Weitzel is a clinical social worker with the EPiC Team, a multidisciplinary consultation service that identifies and manages health care superutilizers, at the University of Illinois at Chicago. Stephen Brown (sbbrown9@uic.edu) is director of preventive emergency medicine at the University of Illinois at Chicago and project leader for the EPiC team. The patient's name and certain identifying details were changed to protect his family's privacy.
authors.forename: Stephen
authors.initials: S
authors.lastname: Brown
mesh_terms: D000328:Adult; D001741:Black or African American; D002641:Chicago; D018450:Disease Progression; D017809:Fatal Outcome; D006801:Humans; D007902:Length of Stay; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D033262:Narration; D010343:Patient Admission / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011369:Professional-Patient Relations; D064876:Safety-net Providers / Q000191:economics / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000628:therapy*
keywords: Determinants Of Health; Disparities; Legal/Regulatory Issues; Mental Health/Substance Abuse; Personal Experience (-Narrative Matters-)