Nurse Transporting senior patient in a wheelchair smiling


Patient and Family Care Transitions Upon Discharge: Ensuring Success Together


Williams Alison2   Source

Alison Williams

Vice President of Clinical Quality Improvement





  • Care Coordination
  • Quality and Safety


care coordination quality and safety quality brief

Hospitals challenged by Medicare and other payers to reduce the length of hospital stays are often discharging patients sooner than patients and families expect. At the same time, through the Hospital Readmissions Reduction Program, hospitals are under pressure to reduce preventable readmissions among five clinical conditions. Hospitals are faced with the task of preparing patients and families to provide ongoing care at home and by ensuring they understand how to self-manage the clinical condition. Unfortunately, patients often go home, where with little or no professional assistance, family members must provide complex and
difficult care. Not only must spouses and adult children help with activities such as bathing, feeding and lifting their loved ones; they also must take on complicated medical care that would otherwise be handled by highly-trained nurses.

This issue brief highlights the most common failure points associated with hospital discharge, offers practical tools and effective strategies for hospital staff and caregivers, and shares valuable insights from the patient perspective.

read the brief

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