The Care Transitions Intervention

Abstract

An expanding evidence base demonstrates that serious deficiencies in quality exist for patients undergoing transitions across sites of care. Qualitative studies^1-7 produced consistent results, demonstrating that patients are often unprepared for their self-management role in the next care setting, receive conflicting advice regarding chronic illness management, are often unable to reach an appropriate health care practitioner who has access to their care plan when questions arise, and have minimal input into their care plan.