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transitions of care

Improve Your Care Transition Process

Enhance communication and accountability to improve resident satisfaction and care

How Do You Define a Successful Transition?

Implementing an effective care transition process is an important step in reducing hospital readmissions and costs. Transitions are especially difficult on our seniors and their families who may be confused about what's happening and what they need to do. The successful transition process ensures clear communication to all parties, proper education to the resident and their family, and clear assignment of accountability for all involved.



Improve communication during transitions between providers, patients and family caregivers.



Use appropriate strategies to enhance patient and family education.



Establish points of accountability for sending and receiving care.

Transitions of Care Tools and Resources

Download these helpful resources to help implement an effective care transition process.

Implementing Proper Transitions of Care to Prevent Rehospitalization

In the post-acute care continuum, individuals may utilize multiple types of providers, including individual healthcare providers and healthcare organizations, during the course of an acute illness or chronic disease. Failure to meet the individual’s needs during a transition have a myriad of effects on the individual’s health.

Join Jennifer Moore, RN-BC, DNS-CT, as she discusses how to implement appropriate systems to improve care transitions and prevent negative outcomes such as avoidable rehospitalizations.

Watch this webinar

Transitions of Care Course Preview

According to the Medicare Payment Advisory Commission, or MedPAC, 17.6% of admissions to the hospital in 2005 were readmitted within 30 days of discharge. This accounted for $15 billion in Medicare spending. Worse, it was determined that 13% of these readmissions could have been avoided.

Among the likely reasons were shortfalls in the process of changes between caregivers that caused an inadequate relay of information, inadequate follow-up care, and medical errors. Luckily, all of these can be prevented by implementing effective transitions of care.

Preview this course

Improve Your Transitions of Care

Care transitions are especially difficult on our seniors and their families who may be confused about what's happening and what they need to do. Furthermore, poor transitions can result in hospital readmissions and costs. Learn more about the courses we have to prepare your staff with the skills they need to improve care transitions.

Download the fact sheet