The most cited explanation for the fragmentation of America's health care system is
the lack of information that flows between health care providers.
1
,
- Snow V.
- Beck D.
- Budnitz T.
- et al.
Transitions of care consensus policy statement American College of Physicians-Society
of General Internal Medicine-Society of Hospital Medicine-American Geriatrics Society-American
College of Emergency Physicians-Society of Academic Emergency Medicine.
J Gen Intern Med. 2009; 24: 971-976
2
,
3
Providers in acute care settings often have little knowledge of the care that occurred
prior to hospitalization. Likewise, outpatient workups may occur among an assortment
of specialists, each potentially working from their own unique perspective within
health care networks that may not communicate redundancy and changes with other members
of the health care team. As such, each care setting represents its own microenvironment
of care with health care transitions, or movement between silos of care, expected
to rise in frequency and complexity as the adult population ages.
4
,5
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References
- Transitions of care consensus policy statement American College of Physicians-Society of General Internal Medicine-Society of Hospital Medicine-American Geriatrics Society-American College of Emergency Physicians-Society of Academic Emergency Medicine.J Gen Intern Med. 2009; 24: 971-976
- Falling through the cracks: challenges and opportunities for improving transitional care for persons with continuous complex care needs.J Am Geriatr Soc. 2003; 51: 549-555
- Healthcare transitions of older adults: an overview for the general practitioner.R I Med J (2013). 2014; 98: 15-18
- Quality care outcomes following transitional care interventions for older people from hospital to home: a systematic review.BMC Health Serv Res. 2014; 14: 346
- The Older Persons' Transitions in Care (OPTIC) study: pilot testing of the transition tracking tool.BMC Health Serv Res. 2013; 13: 515
- Emerging lessons from regional and state innovation in value-based payment reform: balancing collaboration and disruptive innovation.Milbank Q. 2014; 92: 568-623
- Community–based transitions program.(Accessed September 26, 2021)
- Integration activities between hospitals and skilled nursing facilities: a national survey.J Am Med Dir Assoc. 2021; 22: 2565-2570.e2564
- Organizational relationships between nursing homes and hospitals and quality of care during hospital-nursing home patient transfers.J Am Geriatr Soc. 2007; 55: 1078-1084
Article info
Publication history
Published online: March 04, 2022
Footnotes
This Drs Vognar and Dosa report no relevant conflicts of interest. This material is based upon work supported in part by the Department of Veterans Affairs. The views expressed in this editorial are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government.
Identification
Copyright
Published by Elsevier Inc. on behalf of AMDA - The Society for Post-Acute and Long-Term Care Medicine.
