Direct Care Workers (DCW) provide both personal care to patients and emotional support caregivers in hospice palliative care. DCWs often develop close ties are then expected work with new clients immediately following a transition, little or no time grieve. A qualitative pilot study (n = 24) was conducted explore the experience of during transitions. Data collected via focus groups individual i...

INTRODUCTION Patients with complex medical care needs often embark on multiple care transitions over an extended period of time. As these patients or their caregivers often become the chief source of communication for complex medical situations, each transition can create an opportunity for health care errors. Combining the efforts of the established departments of Chronic Care Coordination (CC...

A unified picture of the scaling and non-scaling behavior in quantum Hall plateau transitions is proposed. We show that the interband mixing of states with opposite chiralities and the degrees of the inter-Landau-band overlap are the key ingredients to the problem. We find that the mixing of states with opposite chiralities tends to delocalize electronic states, leading to the formation of exte...

The purpose of this article is to describe The Joint Commission's 7 foundations of safe and effective transitions of care to home: (a) leadership support; (b) multidisciplinary collaboration; (c) early identification of patients/clients at risk; (d) transitional planning; (e) medication management; (f) patient and family action/engagement; and (g) transfer of information. These foundations were...

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 ...

Although the health care reform movement has brought about positive changes, lingering inefficiencies and communication gaps continue to hamper system-wide progress toward achieving the overarching goal-higher quality health care and improved population health outcomes at a lower cost. The multiple interrelated barriers to improvement are most evident in care for the population of patients with...