- How can health care providers identify patients with various risks, such as readmission or death within a year of hospitalization?
- How can providers determine eligibility for different kinds of care, such as home-based and palliative?
- How can providers screen for dementia, pain, and social and spiritual needs?
This resource is a toolkit for identifying patients with various physical, functional, emotional, social, and spiritual needs.
- Patients and families living with serious illness have a range of needs beyond disease treatment, including support for functional limitation, pain and other symptoms, and caregiver burden.
- This toolkit includes resources for inpatient providers, community-based providers, systems, plans, and accountable care organizations (ACOs).
- It also includes clinical assessment tools and information for patients about palliative care.
- Some of the resources in the toolkit are open-access and some are accessible by CAPC members only.