At one urban academic health system, an acute care intervention bundle to improve transition planning after discharge was associated with large reductions in total cost of care, especially among Medicaid patients, ... For Medicare patients, the
Establish and report patient self-determination of care documentation, including explicit do-not-attempt-resuscitation status, as a routine practice in all admissions. ... The HOSPITAL score, which can be used for all patients regardless of their main
Transitions of care can be dangerous for patients and frustrating for physicians. ... and that discharge summaries were often unavailable at patients' first posthospital office visits, affecting quality of care 25% of the time.
Overall, 75.9% of the primary care clinicians and 40% of the hospitalists were women. ... They concluded that hospitalists and primary care clinicians have similar concerns about continuity of care and believe direct communication at care transitions is
16 score of 80.621.1 in the intervention group versus 79.921.4 in the usual care group. ... for studying large-scale interventions related to transitions of care in acute stroke.
Both outcomes were adjusted for age, sex, risk score, dual eligibility for Medicare and Medicaid, type of discharge, year of discharge, and receipt of home health care. ... Like any improvement on the standard of care, diffusion of TCM will require
Results of the retrospective analysis were published online March 23 by JAMA Cardiology. ... The authors noted limitations to their study, such as its retrospective design and the likelihood of residual confounders.
I am not at all surprised that having the same group of doctors for inpatient and outpatient care helps with transitions of care and mortality. ... Our initiative to encourage primary care physicians to contribute to the care of their inpatients grew out
Hospitalists, by the nature of their practice, are in an ideal position to teach about transitions of care. ... Hello, I am Dr. Hedges. I will be part of your care team.
Dr. Masica, along with colleagues in care coordination, administration and pharmacy, wanted to address several of these problem areas at once. ... I wouldn't claim that we have solved the transitions of care problem.