Evidence Supports Transitional Care Programs Essay

Evidence Supports Transitional Care Programs Essay

Evidence supports transitional care programs as a means of improving quality of patient care and reducing 30-day readmission rates. Multiple models exist and all center on common goals of early patient identification, disease-specific patient education, medication reconciliation and education, office follow-up and timely coordination of care and sharing of medical records penitent to patient’s case.

METHODS

Design

This project was an observational study designed to evaluate the impact of Post-MI Transitional Care Program and Advanced Practice Provider Transitional Care Clinic on 30-day readmission rates, medication compliance and length of time to first office follow-up. Retrospective chart review was used to gather data. Prior to October 1, 2015, no formal Transitional Care Program or Advanced Practice Provider Transitional Care Clinic existed at Baptist Hospital. On October 1, 2015, Baptist began a Post-Myocardial Infarction Transitional Care Program and Advanced Practice Provider Transitional Care Clinic which incorporated multiple discipline inpatient education and structured post-discharge clinic which was managed by advanced practice providers who provide comprehensive patient care for the first 30 days after discharge with diagnosis of myocardial infarction.

Population

Sample. Using discharge diagnosis, 2 samples were collected. Sample 1, was composed of all patients discharged with diagnosis of myocardial infarction at Baptist Hospital during the period of
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