Transitions in Care

Active Roles for Older Adults in Navigating Care Transitions: Lessons Learned from the Care Transitions Intervention

Older persons suffer from complex and chronic health conditions that require ongoing self-care activities as well as management by health care professionals. Older adults commonly receive care in multiple settings (hospital, skilled nursing facility, ambulatory clinic, home) necessitating transitions between settings of care. Multiple strategies have been proposed to aid care coordination betwe...

The Residential Long-Term Care Role in Health Care Transitions.

The objective of the current study is to describe the activities long-term care facilities are undertaking to reduce hospital admissions and readmissions by working to improve health care transitions. The data were collected via an online survey from 888 nursing facilities (NFs) and 527 residential care facilities (RCFs) that completed the care integration module of the Ohio Biennial Survey of ...

Transitions of care in anticoagulated patients

Anticoagulation is an effective therapeutic means of reducing thrombotic risk in patients with various conditions, including atrial fibrillation, mechanical heart valves, and major surgery. By its nature, anticoagulation increases the risk of bleeding; this risk is particularly high during transitions of care. Established anticoagulants are not ideal, due to requirements for parenteral administ...

Pharmacist Role in Transitions of Care.

AMDA national engagement in care transitions.

To the Editor: I was delighted to read your excellent editorial entitled ‘‘Transitions’’ in the November 2010 issue of the Journal of the American Medical Directors Association. The issue of safe movement for all patients, especially frail elders, has rightly assumed a seat at the table of national health care concerns. The projected annual cost of $17.4 billion in readmissions for 2003–2004 cl...