A Closer Look at Transitional Care Management

If you have suffered an injury, undergone major surgery, or experienced a life-changing event, such as a stroke or heart attack, you know moving from a health-care setting to another setting can be challenging.

And this change can be especially challenging if you're going from a health care setting to home. Suddenly you assume a larger responsibility in keeping track of medications, doctors, and other health-care related issues.

If you’re going from a medical facility to home, there’s an option that can help with the transition. It’s called transitional care management. In this blog, the experts at Generations Family Practice in Cary, North Carolina, explain what transitional care management is all about. 

The basics of transitional care management

If you’ve ever had an issue that required medical care, you’re likely aware that keeping track of medications and doctors’ appointments can get complicated quickly. Even under the best circumstances, communication can break down. 

Experts estimate that 30% of patients transitioning from a hospital or inpatient care setting to home have at least one discrepancy between their discharge list of medications and the ones they usually take. It’s no wonder, then, that about 20% of all patients have some sort of preventable health problem within three weeks of returning home.

This is where transitional care management comes in.

The overarching goal of transitional care management is to take the pressure away from the patient or caregiver and replace it with a personalized coordinated services plan. This can allow the patient to receive all the resources, services, and tools they need to get proper medical care without placing the burden squarely on their shoulders.

Although it differs from patient to patient depending on the condition being treated, the typical transitional care management plan lasts about 30 days.

Services involved in transitional care management

In addition to helping you keep track of your medications, doctor visits, and other things related to your medical issue, Generations Family Practice can provide a number of other services, such as the following:

Physical rehabilitation

For many patients, restoring movement and mobility are at the top of their transitional needs. Our program offers physical rehabilitation therapy, which can be complimented by acupuncture or massage therapy to enhance mobility and promote healing.

Pain management

Similarly, the healing and transitional process often revolves around the need to control pain. Our highly skilled team offers a vast array of pain-relieving solutions, including osteopathic manipulation and joint injections, which work well with massage and physical therapy.

Chronic care management

For some of our transitional care management patients, their underlying medical condition is something they’ll have for the rest of their life. The important thing to remember is that just because you have a serious medical issue, such as a heart problem or diabetes, doesn’t mean you can’t live a long and productive life. There are plenty of things you can do to lower your risk of developing complications and reduce unpleasant symptoms through chronic care management.

Smoking cessation

Quitting smoking may be the most difficult lifestyle change that patients ever have to tackle. At Generations Family Practice, you won’t have to go it alone. We offer highly effective smoking cessation programs and treatments that can help you kick tobacco and nicotine to the curb for good.

Transitional care management can improve patient outcomes

Although the sheer volume of multidisciplinary services often connected to transitional care management is impressive, the most important takeaway is that research suggests that transitional care management programs work. Not only can they improve patient outcomes, but they can also prevent the need for hospital readmissions.

If you have a chronic medical condition or are about to undergo a major surgery and want to learn more about transitional care management, call 919-852-3999 or book an appointment online with Generations Family Practice today.