Grand-Aides Aim to Reduce Readmissions and Improve Transitions in Care

American Journal of Managed Care | American Journal of Managed Care

Readmissions are one of the many Achilles’ heels of healthcare. Whether it is a failure in communication, problems with medication adherence, or an overall lack of quality healthcare delivery, readmissions cause many headaches within the system. Saturday at the American College of Cardiology 62nd Annual Scientific Session and Expo featured a discussion on successful transitions of care to help prevent readmissions. Arthur Garson, Jr, MD, MPH, MACC, Director, Center for Health Policy, University of Virginia, spoke about the role of a Grand-Aide and how these specially trained professionals have the potential to drastically reduce readmission rates.

Dr Garson focused on the ways in which tomorrow’s health workforce can be leveraged to bring forth innovative healthcare delivery for the management of chronic diseases, focusing specifically on the role of the Grand-Aide. He defined this role as a Certified Nurse Aide that has been trained with a specified curriculum for an additional 200 hours in medical care to be an extender for a nurse, nurse practitioner, case manager, or a physician. The goals of a chronic care Grand-Aide are as follows:

• Improve health process measures and outcomes
• Reduce 30-day readmissions by 25%-50%
• Reduce length of stay for all admissions (including readmissions)
• Reduce cost

Grand-Aides also leave the hospital with patients that have chronic disease and accompany them home and visit the patient 1 to 2 days before their discharge. Once at the patient’s home, the Grand-Aide assists the patient in developing regimens for medication adherence as well as other parts of the treatment plan, such as diet, weight goals, and what symptoms and signs the patient would need to advise their physician about. Grand-Aides visit the patient daily during the first week and decrease their visits over the first 30 days, although frequency may fluctuate depending on the status of the patient’s illness or medication adherence.

In addition to onsite assistance, Grand-Aides are trained in the proper use of medical technology, and often times are the first-level troubleshooters for equipment issues. There are approximately 20 locations in the United States currently that employ the use of Grand Aides, and Dr Garson finished up his presentation by stressing some of the qualities Grand-Aide programs possess that differentiate them from others, such as a distinct training program (200-400 page manual) and the ability to provide and inexpensive workforce (the median is $13.00/hr).

In an era of healthcare delivery that is rampant with gaps in care and communication breakdowns, the role of the Grand-Aide is one that is accomplishing a lofty goal—a new model of healthcare delivery with personalized care at a lower cost.

For more on the role of Grand-Aides and how this position continues to evolve and assist in the delivery of patient-centered care, please visit