Mismatched Needs and Services Can Lead to Harm: A Systems REThinking Approach

October 11, 2018 | Aging Services Risk, Quality, & Safety Guidance

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​Effective preadmissions, admissions, discharge, and care transition processes, as well as other processes that inform and support the scopes of service within the organization, have many components, and they are interconnected with other facets of the care environment (see the shaded circles in Figure 1. Scope of Service and the Care Environment: A Systems Thinking Perspective). It takes the combined efforts of many stakeholders and disciplines as well as the person served and, when involved, the family. ​

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Scope of service helps to draw a picture of the many types of care and services a delivery system provides to care for and support the ongoing health and needs of the person served. It might help to visualize scopes of service as the dotted-line ovals represented in Figure 2. Drawing a Picture: Scopes of Service across the Care Continuum. Each oval represents the bundled care and services that a provider organization puts together to create a service line. This works for stand-alone provider organizations throughout the aging services continuum, as well as CCRCs and life plan communities.

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When analyzing scope of service, consider the continuums of care within and across community health systems, provider health systems, and individual provider organizations. Having a degree of overlap can help provide flexibility and person-centered care (see Figure 3. The Ideal: Appropriate Overlap in Scopes of Service...

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