Impact of a transitional care program for heart failure patients at Baylor Scott & White Health: a pilot study.

Heart failure is a chronic health condition characterized by complex symptom management and costly hospitalizations. Hospitalization for the treatment of heart failure symptoms is common; however, many hospitalizations are thought to be preventable with effective self-management. This study describes the small, pilot implementation of a new, interventional, self-management heart failure program, "Engagement in Heart Failure Care" (EHFC), developed to assist heart failure patients with the management of disease symptoms following discharge from an inpatient hospital stay.

The community-based LIVE WELL Initiative: Improving the lives of older adults.

A collaborative partnership among community-based organizations (CBOs) could strengthen local services and enhance the capacity of a community to provide services as well as meet the diverse needs of older adults. The United Way of Tarrant County developed the LIVE WELL Initiative, partnering with six CBOs to provide nine evidence-based or evidence-informed health interventions to improve the health and lower healthcare costs of vulnerable individuals at risk for poor health. The nine programs include specific target areas, such as falls prevention, chronic disease self-management, medication management, and diabetes screening and education.

D-CARE: The Dementia Care Study: Design of a Pragmatic Trial of the Effectiveness and Cost Effectiveness of Health System-Based Versus Community-Based Dementia Care Versus Usual Dementia Care.

Background/objectives: Although several approaches have been developed to provide comprehensive care for persons living with dementia (PWD) and their family or friend caregivers, the relative effectiveness and cost effectiveness of community-based dementia care (CBDC) versus health system-based dementia care (CBDC) and the effectiveness of both approaches compared with usual care (UC) are unknown.

Design: Pragmatic randomized three-arm superiority trial. The unit of randomization is the PWD/caregiver dyad.