Streamline patient care by automating transitions from hospital to home, reducing readmissions and improving quality of life through efficient communication and coordinated care planning.
Type: Fill Checklist
In this initial step of the care transition process, it is essential to understand how patients move through various stages of healthcare services. This involves mapping out the patient journey from hospital discharge to post-acute care facilities or home-based care. The goal is to identify critical points where information exchange and communication are necessary to ensure continuity of care. Key aspects of this step include: * Defining entry and exit criteria for different levels of care * Identifying roles and responsibilities at each stage * Mapping patient flow through various care settings * Recognizing areas of potential gaps or fragmentation in care
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