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21. Transitional Care Medication Safety: Stakeholders' Perspectives | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/patient-safety/reports/liability/corbett.html
    August 01, 2017 - The transition from hospital to community settings is an exceptionally risky time for patients. 4-8 … Theme 1: Barriers to medication safety during transition from hospital to home. … due to illness severity and/or functional impairment. 29 During this fragile transition, patients and … Preventing or promptly resolving medication discrepancies during the hospital to home transition are … The hospital discharge: A review of high risk care transition with highlights of a reengineered discharge

22. Section 7.E, Tables 15 and 16 (pdf file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/chronic/chipra-166-fecc-tables-15-16.pdf
    March 12, 2018 - 26.2 50*** Protocols/Plans Child has shared care plan FECC-16 40.8 61.8*** Child has written transition … 26.9 49.4*** Protocols/Plans Child has shared care plan FECC-16 40.9 64.8*** Child has written transition

23. Chapter 6. Measure Maps and Profile | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/ncepcr/care/coordination/atlas/chapter6.html
    June 01, 2014 - . ‡ All measure items addressing transitions were mapped to one of the specific transition types ( across … Index of Measures . ‡ All measure items addressing transitions were mapped to one of the specific transition … Transition Record with Specified Elements Received by Discharged Patients (Inpatient Discharges) 59 … Timely Transmission of Transition Record 60. … Transition Record with Specified Elements Received by Discharged Patients (Emergency Department Discharges

24. Overview | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/pqmp/implementation-qi/toolkit/h2h/overview.html
    July 01, 2021 - An effective transition will support the likelihood of reducing the incidence of inappropriate care and … provided a starting place for identifying best practices for improving performance on the hospital-to-home transition

25. Section 7.B, Tables 13 and 14 (pdf file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/chronic/chipra-166-fecc-tables-13-14.pdf
    March 09, 2018 - -14 33.3 28.6 Protocols/Plans Child has shared care plan FECC-16 40.0 48.8* Child has written transition … child’s condition Protocols/Plans Child has shared care plan FECC-16 40.9 49.1 Child has written transition

26. TeamSTEPPS Rapid Response Systems Module | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/teamstepps/rrs/instructor_slides/rrsinstructmod.html
    October 01, 2014 - Support ("Boundary Spanning") Transition Support ("Boundary Spanning") (continued) Example of One … How did the response team know when and where to transition the patient to another care unit? … Did the Responders understand the role of the nursing staff in easing transition? … Return to Top Transition Support ("Boundary Spanning") Say: Transition support, or "boundary … This transition of care can include: Transferring the patient to another unit.

27. Section 7.A, Tables 11 and 12 (pdf file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/chronic/chipra-166-fecc-tables-11-12.pdf
    March 09, 2018 - Protocols/Plans Child has shared care plan FECC-16 36.4 52.4*** 65.9*** 41.2 Child has written transition … Protocols/Plans Child has shared care plan FECC-16 37.5 53.7*** 62.6*** 40.8 Child has written transition

28. Module-8-Slides (pdf file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/takeheart/training/module-8-slides.pdf
    November 18, 2021 - Clinician-to-clinician hand-off to inpatient/rehab CR Programs  Phase II collaboration Phase I transition … to Phase II PARTICIPANTS 30 Phase I GOAL: Strive for a smooth, timely transition Phase II Develop … education visit – Inpatient CR  Time from Referral to Enrollment and/or attendance at first session --Transition …  Percentage of referrals who enroll -- Transition  Percent of patients attending CR orientation

29. Design Guide for Warm Handoff Plus (pdf file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-family-engagement/pfeprimarycare/warm-handoff-design-guide-final508.pdf
    April 03, 2018 - In each transition, opportunities arise for breakdowns in communication that may lead to medical errors … A Warm Handoff Plus is a transition conducted in person between two members of the healthcare team in … Identify patient transition points within the practice. … For each transition identified in Step 1, determine: � Who is handing off the patient or information

30. Supplemental Items for the CAHPS Hospital Adult Survey: Health Literacy | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/cahps/surveys-guidance/item-sets/literacy/suppl-healthlit-items.html
    October 01, 2023 - Add a transition statement to indicate a transition from the HCAHPS questions. … To find CMS’s mandatory transition statement, please refer to the HCAHPS Quality Assurance Guidelines … on HCAHPS and search for “mandatory transition statement.”

31. About the Measure | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/pqmp/implementation-qi/toolkit/h2h/about.html
    July 01, 2021 - and content of discharge instructions to families/caregivers are essential for ensuring a successful transition … The measures for this toolkit were developed to capture the quality of care coordination in transition

32. Chapter 6. Measure Maps and Profiles (continued, 20) | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/ncepcr/care/coordination/atlas/chapter6s.html
    June 01, 2014 - report. 1 This measure is intended for use in conjunction with two other PCPI measures (Measure #58, Transition … Transition Record with Specified Elements Received by Discharged Patients (Inpatient Discharges) Care … Transition Record with Specified Elements Received by Discharged Patients (Inpatient Discharges) Purpose … from an inpatient facility to home or any other site of care, or their caregiver(s), who received a transition … Reconciled Medication List Received by Discharged Patients; and Measure #59, Timely Transmission of Transition

33. Toolkit to Engage High-Risk Patients In Safe Transitions Across Ambulatory Settings | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/hai/tools/ambulatory-care/safe-transitions.html
    December 01, 2017 - Patients who transition from one ambulatory care facility clinician to another are especially vulnerable

34. THE MEDICAL HOME INDEX: (doc file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/demoeval/what-we-learned/mhi-rsf.docx
    March 25, 2009 - Pediatric and adolescent PCPs support youth & family to manage their health using a transition time line … Adult providers offer an initial "welcome" visit and a review of transition goals. … In addition to level 3, progressively from age 12, youth, family and PCP develop a written transition … Youth and families receive coordination support to link their health and transition plans with other … Transition to adulthood indicator #2.5 revised 2006; Medical Home Index revised to create MHI-RSF 2012

35. The Medical Home Index: Revised Short Form: Pediatric | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/policymakers/chipra/demoeval/what-we-learned/mhi-rsf.html
    May 01, 2013 - COMPLETE __ PARTIAL __ COMPLETE __ PARTIAL __ COMPLETE __ PARTIAL __ COMPLETE 7 #2.5 Supporting the Transition … Pediatric and adolescent PCPs support youth & family to manage their health using a transition time … Adult providers offer an initial "welcome" visit and a review of transition goals. … In addition to level 3, progressively from age 12, youth, family and PCP develop a written transition … Youth and families receive coordination support to link their health and transition plans with other

36. TeamSTEPPS Rapid Response Systems Module | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/teamstepps/rrs/rrs_slides/rrsslides.html
    July 01, 2018 - Teamwork & RRS Necessary Teamwork Skills Inter-Team Knowledge Inter-Team Knowledge (continued) Transition … Support ("Boundary Spanning") Transition Support ("Boundary Spanning") (continued) Example of One … Assessment & Stabilization CUS Words Patient Disposition Patient Disposition (continued) RRS Transition … Inter-Team Knowledge Supports effective transitions in care between units Is a prerequisite for transition … Return to Top Transition Support ("Boundary Spanning") Requires inter-team knowledge Combines

37. Medication Discrepancies and Potential Adverse Drug Events During Transfer of Care from Hospital to Home | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/patient-safety/reports/liability/neumiller.html
    August 01, 2017 - costs associated with preventable ADEs occurring in both inpatient and outpatient settings. 8,9 The transition … patients may result in ADEs. 29 Such human factors resulting in ADEs are particularly common during transition … that can help identify patients who may be at risk for experiencing medication-related ADEs during transition … Conclusion Medication discrepancies frequently occur during the transition from hospital to home care … The hospital discharge: a review of high risk care transition with highlights of a reengineered discharge

38. AHRQ's Digital Solutions to Support Care Transitions Challenge | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/challenges/past/care-transitions/index.html
    January 01, 2022 - hospital, primary care, and community partner care teams throughout the hospital discharge to home transition … Hospital Discharge   Colorado UTHealth MyInfantCare—A Digilego App to Assist Parents in a Successful Transition

39. Transitioning Newborns from NICU to Home | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/patient-safety/settings/hospital/resource/nicu/index.html
    June 01, 2021 - Resource Toolkit This toolkit includes resources for hospitals that wish to improve safety when newborns transition

40. SITUATION MONITORING (ppt file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/rrs/rrsinstructmod.ppt
    January 01, 2008 - How did the response team know when and where to transition the patient to another care unit? … Did the Responders understand the role of the nursing staff in easing transition? … An example of transition support is an individual who serves on more than one team in an assembly line … ”) SAY: In the context of the RRS, transition support applies to the liaison roles taken on by nurses … This transition of care can include: Transferring the patient to another unit.