Scenario: Rebecca Snyder, 56, is the matriarch of a traditional Orthodox Jewish family. She is the mother of five, including two teenagers at home, and the grandmother of seven. She was brought into the emergency room with uncontrolled diabetes and hyperglycemia. The doctors discovered other problems, and unfortunately Mrs. Snyder was diagnosed with advanced ovarian cancer.she is the primary caregiver in her family, she and her family are especially ill-prepared for this serious diagnosis. You will be responsible for investigating this situation and for helping Mrs. Snyder and her family get the care and support they need.

As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as part of your assessment.

What are the likely outcomes of poor care transitions among providers and health care settings?
Why is effective communication such a vital component of transitional care?
Where are communication breakdowns likely to occur?
Why?
Have you seen or experienced such breakdowns in your own practice setting?

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