Eric A. Coleman, MD, MPH; Robert A. Berenson, MD
Grant Support: By Paul Beeson Faculty Scholars in Aging Research/American Federation for Aging Research.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Eric A. Coleman, MD, MPH, Divisions of Health Care Policy and Research and Geriatric Medicine, University of Colorado Health Sciences Center, 13611 East Colfax, Suite 100, Aurora, CO 80011; e-mail, Eric.Coleman@uchsc.edu.
Current Author Addresses: Dr. Coleman: Divisions of Health Care Policy and Research and Geriatric Medicine, University of Colorado Health Sciences Center, 13611 East Colfax, Suite 100, Aurora, CO 80011.
Dr. Berenson: The Urban Institute Health Policy Center, 2100 M Street NW, Washington, DC 20037.
Coleman E., Berenson R.; Lost in Transition: Challenges and Opportunities for Improving the Quality of Transitional Care. Ann Intern Med. 2004;141:533-536. doi: 10.7326/0003-4819-141-7-200410050-00009
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Published: Ann Intern Med. 2004;141(7):533-536.
As national awareness of medical errors and quality deficiencies that occur within particular care settings continues to rise (1), an expanding evidence base points to similar problems that occur during care transitions. Transitional care has been defined as a set of actions designed to ensure the coordination and continuity of health care as patients transfer between different locations or different levels of care in the same location (2).
Although a comprehensive review of this literature is beyond the scope of this article, we used the following search terms in MEDLINE (1990 to present) to identify the most relevant articles: transitional care, care transition, care coordination, care transfer, continuity of care, and hospital discharge. Most articles retrieved are predominantly descriptive and focus on patient's care needs during transitions. Few provide evidence-based suggestions for physicians; however, a consensus conference attempted to identify key roles for the sending and receiving care team (3), and a recent report details best practices for transitional care in managed care organizations and includes programs in which physicians have substantial roles (4). In contrast, controlled studies show compelling evidence that management of transitional care by advance practice nurses can reduce rates of rehospitalization for patients with congestive heart failure and for older patients with complex care needs (5-10).
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Hospital Medicine, Healthcare Delivery and Policy, Prevention/Screening.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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