18
Aug

How a little information can go a long way to improving health outcomes

Access to reliable transportation is a major concern for many seniors, who can often find it difficult to attend medical appointments. Here’s how a visit from a care transitions coach helped one senior solve the problem. Shamael, one of Partners’ care trans...

7
Dec

“She was full of information about useful resources and was ready to help us right away.”

Magda* was born and raised in Transylvania, Romania. Eighteen years ago, at the age of 70, she moved to the US to be near her family. Magda had always enjoyed good health until, in August 2014, she was diagnosed with an intestinal tumor. The news was devast...

15
Oct

Daniel’s story – ” My coach made me aware that I was not taking my medications as prescribed.”

Daniel Dominguez, who received care transitions coaching following his release from UCLA Medical Center, wrote to Partners CEO, June Simmons, to express his gratitude for the services he received. It sure did make our day. Thank you, Daniel!

15
Oct

Eva’s* story – “The coach was very helpful in explaining options and services.”

Eva,* 53, was referred to the Community Care Transitions Program after receiving treatment at Glendale Adventist Hospital following a fall. She has a number of chronic health conditions including, diabetes, anemia, high blood pressure, degeneration of a lum...

15
Oct

“My coach told me I should switch to a doctor who spoke Spanish. Now I understand what’s going on.”

Coach Jesus had to educate patient Antonio about his doctor’s rightful role in his ongoing health. He assumed doctors were only there for illness, not wellness. The first step was switching to a Spanish‐speaking provider, which facilitated communication on ...

15
Oct

“My coach found every resource I needed ‐ and it wasn’t easy!”

A Bodfish, CA resident gave Coach Ida a run for her care transition money. In his 60s with multiple chronic conditions and recovering from addiction, he needed post‐discharge food, transportation and legal aid. The Bakersfield meals on wheels program didn’t...

15
Oct

“My coach helped me understand the importance of communicating with my doctor.”

Margarite was grateful for the visit from her coach, Adrine, and her encouragement and guidance on following up with the doctor. She had not planned to do so, but because Adrine helped her identify some medication red flags, she realized the wisdom of an ed...

15
Oct

“My mom had multiple prescriptions for the same thing. The Personal Health Record has helped us make sense of things.”

Before hospitalization, Mabel had been in charge of her own medications. But after discharge, her escalating confusion concerned her family, so they concentrated the coaching session on medication reconciliation. In that process, Mabel’s daughter realized t...

15
Oct

“My mother couldn’t get to her doctor appointments. Her coach found a solution.”

Maria’s mom was released from the hospital following treatment for an infection on her leg caused by a dog bite. Her mom was also showing signs of memory problems that made it difficult for her to get to doctor appointments without assistance. Unfortunately...