Care Transitions Support
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Karie Untiedt
Director of Quality and Patient Safety
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- 573-893-3700| ext. 1369
Enhancing Care Transitions for Better Patient Outcomes
Care transitions refer to the movement of a patient from one health care setting to another, such as from a hospital to a rehabilitation facility, nursing home or home care. These transitions are critical moments in a patient’s care journey and require careful coordination to ensure continuity, safety and optimal health outcomes.
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Looking for more tools and strategies to improve care transitions? MHA provides resources to help hospitals enhance patient handoffs, support self-management and reduce readmission risks.
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The Role of Health Care Workers in Care Transitions
Health care providers play a vital role in engaging patients and families in transition planning. Prioritizing effective communication and support during these transitions helps to:
- Reduce preventable readmissions by ensuring patients receive the right care in the right setting
- Improve self-management practices, empowering patients to take an active role in their recovery
- Enhance coordination between care teams, creating seamless handoffs and minimizing gaps in care
- Support better long-term health outcomes, promoting stability beyond the initial hospital stay
The Importance of Engaging Patients in Care Transitions
Improving care transitions requires a holistic and patient-centered approach. Engaging patients and families in more circular, overlapping, and continual supportive care transitions helps create stronger communication channels, better follow-up care, and a more proactive health care experience.
By integrating patient and family engagement strategies, hospitals and health systems can:
- Ensure clear discharge planning that includes medication reconciliation and follow-up care
- Provide education on self-care practices and recognizing warning signs
- Strengthen collaborative efforts between providers to avoid fragmented care
Through proactive and patient-focused transition planning, health care providers can improve continuity of care, enhance patient satisfaction and contribute to overall population health.