CoIIN State Team Work: Washington
Enhancing the transition of care for infants discharged from the hospital with chronic conditions and/or functional disability
Lead Organization: Washington State Department of Health Children with Special Health Care Needs Program (Title V) and Seattle Children’s Hospital
Family/Youth Engagement Partner: Partnerships for Action, Voices for Empowerment (PAVE)
Clinical Site: Seattle Children’s Hospital
Project
The CMC CoIIN Washington team worked together to improve the transition of care and establish medical homes for children, birth to 1 year, discharged from the hospital with at least one chronic condition and/or functional disability. The project is under the leadership of Seattle Children’s Hospital and PAVE family leaders.
Outcomes
The team designed an intervention to better assist families of CMC infants recently discharged from the hospital. Supplemented with care coordination, the team established a roadmap to include community resources, primary care medical homes, nutrition services, early intervention programs, parent peer support, and community resource navigational support as care components.
