In this module, you will explore the impact of care transitions between healthcare settings: home to hospital or nursing home; nursing home to hospital or home; and hospital to home or nursing home. Third-party payers are creating incentives and imposing penalties to healthcare organizations who don’t meet expected targets such as 30-day re-hospitalization, catheter-associated urinary tract infections (CAUTI), etc. Not surprisingly, nurses can make a difference. Implementing nurse-driven measures that support continuity of care and consistent communication practices such as follow-up home visits, outreach services, transitional communication tools, discharge planning, and transitional care units improve transitions of patients from the critical care environment to lower level care settings and reduces readmission rates.
Sample Solution
