I would like to welcome Toni O'Donnell to WMHS as our first CARELink coordinator. Toni will be responsible for patient populations at high risk for readmission. She is certified in chronic care and will be able to support chronically ill patients through coordination of care by matching the appropriate resources to the individual needs of each patient.
Toni’s job is to call patients after discharge to ensure that they are complying with their discharge instructions, following up with their care provider, taking their medications and keeping scheduled appointments. As the Care Coordinator, Toni has a variety of care delivery options available to her. She can send nurses to the patient's home, arrange appointments, interact with physicians on individual symptom management, and provide educational resources and telephone triage.
It is our goal to meet the needs of our patients after they are discharged to allow them to remain at home provided they are following their doctor's orders. Although our goal is to keep patients healthy and out of the hospital, it is also important for our patients to know that if they need to be hospitalized that we will continue to be there for them.