Although a growing body of research suggests that social determinants of health—social, functional, environmental, cultural and psychological factors—are intricately linked to health and wellness, our fragmented medical and social services are often underequipped to address these needs. The Ambulatory Integration of the Medical and Social (AIMS) model—developed by the Center for Health and Social Care Integration (CHaSCI) at Rush University Medical Center—integrates masters-prepared social workers into primary care teams to identify, address, and monitor social needs that influence health.
Preliminary evidence indicates that AIMS reduces clients’ emergency department visits, hospitalizations, and readmission rates. AIMS also creates opportunities for community-based organizations (CBO) to develop partnerships with local health clinics to integrate care and promote better health outcomes.
Please join the Aging and Disability Business Institute on April 24 at 1:00 PM Eastern for a one-hour webinar. This webinar will highlight training and implementation support for CBOs interested in replicating AIMS.
Peninsula Regional Medical Center and MAC, Inc., (Maintaining Active Citizens) Area Agency on Aging (AAA) and its Living Well Center of Excellence provide support for patients ready to return home through home- and community-based programs and services to help reduce hospital readmissions.
This webinar will describe the value this partnership brings to the AAA, the healthcare system, providers and, most importantly, to the people being served. Presenters will describe how the relationship began; the value a community-based organization (CBO) adds to service delivery and improved health outcomes; the types of patients who can be helped; the culture change needed to make the partnerships work; and the roles of the healthcare system and the CBO.