Achieving functional integration: a continuum case study.
Inova Mount Vernon Hospital, a part of the Inova Health System in northern Virginia, has developed a plan to redesign its joint replacement service to better coordinate patient care across the entire continuum. The redesign incorporates services, such as presurgery therapy and patient education, registration and insurance activities, rehabilitation, and home care, into an existing acute care joint replacement clinical pathway to create a continuum of care. To encourage the provider partners to integrate the joint replacement service, Inova Mount Vernon Hospital developed new types of clinical, economic, and service outcome measurements to view episodes of care from a system perspective. These measurements will be used to assess the success of the functional integration effort.