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One Patient, Many Places: Managing Healthcare Transitions. Part I: Introduction, Accountability, and Information Transfer.

Coleman EA, Fox PD on behalf of the HMO Care Management Workgroup. One Patient, Many Places: Managing Healthcare Transitions. Part I: Introduction, Accountability, and Information Transfer. Annals of Long-Term Care. 2004;12(9):25-32. http://www.caretransitions.org/documents/One%20Pt%20Many%20Places%20Part%201%20-%20ALTC.pdf . Accessed August 7, 2014. This three-part series addresses how health care organizations (i.e., organized or integrated care systems or large provider groups that receive payment under either a capitated or fee-for-service basis) can improve the quality of transitions among care venues for patients with complex care needs. Poorly executed transitions are associated with inefficiencies and duplication of services that needlessly increase the cost of care and potentially lead to greater utilization of hospital, emergency, post-acute, and ambulatory services. This three-part article includes recommendations for actions that health care organizations can take to improve the quality of care delivered to their patients undergoing transitions. Part I begins with an introduction that is followed by ensuring accountability for patients in transition and facilitating the effective transfer of information.

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