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Transitioning from different healthcare settings can lead to problems

Patient Safety Monitor Alert, March 31, 2004

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Healthcare organizations need to address how they deliver care across different settings to really improve patient safety, according to a new report by the HMO Care Management Workgroup.

The report indicates how providers can improve the care of patients who transition from one healthcare setting to another, such as from a hospital to a skilled nursing facility or back to the patient's home.

Moving between settings can present challenges because often the different facilities don't know exactly what treatment a patient received in the other setting. For example, information about the patient may not be sent to the new facility, it may be incomplete, or the patient might not know exactly what to expect at the next site of care. The report, titled "One Patient, Many Places: Managing Health Care Transitions," includes examples of how providers have addressed transitions. Examples include the following:

>assuring that the patient has a responsible physician at all times and that all providers have the physician's name and contact information

>transferring medical information in a timely manner

>identifying potential problems with multiple physicians prescribing medications in different settings

>ensuring clear communications among the medical practitioners

>preparing patients and their caregivers about what to expect during the course of a transition

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