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RARE - Reducing Avoidable Readmissions Effectively

Community Partners Involvement in the RARE Campaign

The Reducing Avoidable Readmission Effectively (RARE) Campaign seeks to prevent 4,000 avoidable readmissions by Dec. 31, 2012 by engaging hospitals and providers across the continuum of care to focus on this effort. In the initial phase of the campaign, hospitals were recruited and asked to champion change in their organizations that would reduce readmissions.

However, hospital readmissions are not a hospital problem but a system problem.  The RARE Campaign acknowledges that fact by its focus on the continuum of care, and its inclusion of Community Partners to help achieve campaign goals. Community Partners can impact their local communities and constituents, and improve care transitions and services for patients after hospital discharge.

More than 60 organizations have signed on as Community Partners to endorse and support the RARE Campaign.  This document identifies the various types of Community Partners and defines ways they can actively participate based on their role in the care continuum.

Community Partner Criteria

To be a Community Partner, an organization must provide services or support that helps improve care transitions and patient care following hospital discharge. Proprietary vendors of products such as durable medical equipment, drugs, and/or technology software/hardware are not eligible to be Community Partners. Organizations must fall into one of the following categories to be considered a Community Partner:

  • Professional/Trade/Membership Associations
  • Payer Organizations
  • Providers and Provider Groups
  • Community Service Organizations
  • Patient Advocacy Groups

All Community Partners may support the RARE campaign by:

  • Participating in relevant events
  • Educating their constituents on the RARE Campaign and its components
  • Disseminating the monthly RARE Report newsletter and other RARE resources/materials to their constituents
  • Participating in potentially innovative projects where their skills/expertise are needed
  • Educating the organizations leading the RARE Campaign and participating hospitals about their services, needs, issues, challenges, etc.
  • Encouraging patients/consumers to participate in RARE activities or teams
  • Supporting and working where possible to achieve the goals of the campaign
  • Supporting health reforms that align with the Triple Aim of improving the quality of care, the care experience and the affordability of care

In addition,
Professional/Trade/Membership Associations may show support by:

  • Encouraging members to implement RARE strategies in their practice
  • Encouraging members to acknowledge their role in reducing readmissions and to work on quality improvement projects to reduce readmissions
  • Advocating for efforts that align with the goals of the RARE Campaign

Payer Organizations may show support by:

  • Supporting/participating in innovative care and payment redesign efforts
  • Aligning care management activities with provider efforts
  • Educating members (patients/beneficiaries) about self care, activation, engagement (disseminate resources to members)
  • Encouraging providers to participate in RARE efforts
  • Informing the RARE Campaign about their efforts and successes
  • Aligning improvement initiatives with the RARE Campaign

Providers and Provider Groups may show support by:

  • Linking with community care providers to reduce avoidable readmissions
  • Reaching out to participating RARE hospitals to integrate efforts to prevent avoidable readmissions
  • Analyzing their role in reducing readmissions
  • Implementing promising practices for providers identified through the RARE Campaign
  • Educating staff about factors that impact readmissions
  • Supporting/participating in innovative care designs that reduce readmissions
  • Sharing successes with RARE participants and other Community Partners
  • Aligning quality improvement efforts with RARE

Community Service Organizations may show support by:

  • Convening or reaching out to people in their community to facilitate conversations on preventing avoidable readmission
  • Educating the RARE Campaign organizers about the needs of their community

Patient Advocacy Groups may show support by:

  • Educating constituents on the importance of self-management in participating in their own care
  • Providing family care-giver support and resources
  • Educating RARE Campaign organizers about the needs of their populations
  • Encouraging patients/consumers to participate in RARE activities or teams

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RARE is a campaign lead by the Institute for Clinical Systems Improvement, the Minnesota Hospital Association, and Stratis Health, which represents Lake Superior Quality Innovation Network in Minnesota.