Our caregivers are specially trained to implement a successful transition plan from home to hospital, including:
- Reviewing prescriptions and managing medications
- Explaining test results
- Making follow-up appointments
- Providing respite for family members and rehabilitation for the patient to re-enter home life
- Assessing how well doctors and nurses explain the diagnosis, condition, discharge process, and next-steps
- Explaining these processes in plain language to the patient
- Listening to and honoring the patient and family’s goals, preferences, observations, and concerns
Patients returning home from the hospital face a broad range of adverse effects, leading to hospitalizations and readmissions. At Nu Care, we are informed by the most recent medical scholarly literature to inform our care plans assisting patients re-enter home life upon hospital discharge. According to this literature, nearly 20% of elder Medicare patients will be readmitted within 30 days. The transition process from hospital to home can seem overwhelming, and successful strategies must be comprehensive in bridging gaps in care across different healthcare settings, including hospitalizations and outpatient visits. Our transitional care aim to smooth the transition from inpatient to outpatient, preventing unnecessary or avoidable readmissions and adverse events.
Hospital readmissions, based on published studies of hospitalization risk factors, are likely preventable, and due in some part to a lack of care in an outpatient setting. This is all the more reason for our scientific home care approach.
