Launched in 2009, the State Action on Avoidable Rehospitalizations initiative, known as STAAR, aims to reduce rates of avoidable rehospitalization in Massachusetts, Michigan, Ohio, and Washington by mobilizing state-level leadership to improve care transitions. With the program two years into its four-year cycle, 148 hospitals are working in partnership with more than 500 cross-continuum team partners. Although there are no publicly available data on whether the project is achieving its primary goal of reducing avoidable rehospitalizations, the effort has so far been successful in aligning numerous complementary initiatives within a state, developing statewide rehospitalization data reports, and mobilizing a sizable number of hospitals to work on reducing rehospitalizations. More than 90 percent of participating hospitals have formed teams to routinely review rehospitalizations with their community-based colleagues.

This article discusses peer supervision as a vehicle for increasing student responsibility for self-assessment and peer assessment, and increasing independence and interdependence among students for professional and personal growth. The article also explains a model currently in use in a master's degree program in counseling. Included are rationale, definition, implementation, evaluation, and recommendations for use.

In this large academic primary care clinic setting, interdisciplinary team training in QI, support for data collection, and dedicated coaching resources produced few sustainable continuous QI initiatives. Several potentially modifiable barriers to initiation, completion, and sustainability of QI initiatives by primary care teams were identified.

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Purpose – Antibiotic resistance (AR) is a global health crisis that is attracting focussed attention from healthcare, public health, governmental agencies, the public, and food producers. The purpose of this paper is to describe the work in Washington State to combat resistance and promote antimicrobial stewardship from a one health perspective. Design/methodology/approach – In 2014, the Washington State Department of Health convened a One Health Steering Committee and two workgroups to focus on AR, the One Health Antimicrobial Stewardship work group and the One Health Antimicrobial Resistance Surveillance work group. The group organized educational sessions to establish a basic understanding of epidemiological factors that contribute to resistance, including antibiotic use, transmission of resistant bacteria, and environmental contamination with resistant bacteria and antibiotic residues. Findings – The authors describe the varied uses of antibiotics; efforts to promote stewardship in human, and animal health, including examples from the USA and Europe; economic factors that promote use of antibiotics in animal agriculture; and efforts, products and next steps of the workgroups. Originality/value – In Washington, human, animal and environmental health experts are working collaboratively to address resistance from a one health perspective. The authors are establishing a multi-species resistance database that will allow tracking resistance trends in the region. Gaps include measurement of antibiotic use in humans and animals; integrated resistance surveillance information; and funding for AR and animal health research.