http://www.caretransitions.org/index.htm
The term “care transition” refers to the movement patients make between health care practitioners and settings as their condition and care needs change during the course of a chronic or acute illness.
Under the leadership of Dr. Eric Coleman, the aim of the Care Transitions Program is to address the negative consequences of fragmented care, including duplication of services, discontinuity, medication errors, patient and family caregiver distress, unnecessary utilization and higher costs of care.
http://www.caretransitions.org/definations.htm
Care Transitions Intervention was designed in response to the need for a patient-centered, interdisciplinary intervention that addresses continuity of care across multiple settings and practitioners.
http://www.caretransitions.org/...htm
Dr. Coleman and colleagues designed a 15-item uni-dimensional measure to assess the quality of care transitions: the Care Transitions Measure (CTM).
http://www.caretransitions.org/measures.htm
Assessing the quality of preparation for posthospital care from the patient's perspective: the care transitions measure.
Coleman EA, Mahoney E, Parry C.
Med Care. 2005 Mar;43(3):246-55
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?...
Lost in transition: challenges and opportunities for improving the quality of transitional care.
Coleman EA, Berenson RA.
Ann Intern Med. 2004 Oct 5;141(7):533-6
http://www.annals.org/cgi/reprint/141/7/533.pdf
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