The Nathaniel Bowditch Prize is awarded each year to recognize the efforts of a team or individual who has improved the quality of care, while reducing the cost of that care. The 2020 award recipient is the Community Care Transitions Initiative led by Jocelyn Carter, MD, MPH, of the Department of Medicine.
The initiative pairs patients with a community health worker for 30 days following their discharge from the hospital to bridge the gap between the care team and patient to reduce readmissions into the hospital and highlight factors impacting patient outcomes. Community health workers meet patients prior to discharge, and during the 30 days, build connections with patients through phone calls, home visits and clinic and appointment accompaniments. Creating a space for patients to comfortably share concerns and ask questions allows community health workers to connect patients to low or no-cost resources for transportation, housing and food that contribute to poor health outcomes.
In the randomized trial between 2017 and 2019, the initiative collected data from about 500 patients that demonstrated substantially lower 30-day admission rates (45%), emergency department visits (51%) and missed post-discharge appointments (38%). Overall, 94 fewer hospital readmissions, emergency department visits and missed appointments occurred.
The Bowditch Prize is awarded and selected by the Mass General Board of Trustees.