Description:-

Transitional planning is a process that ensures that patients have the best outcomes as they move through the continuum of care.  It has become much more than just the movement of the patient out of the hospital. It is a “process” that starts at the point of admission and follows beyond discharge and through the continuum of care. 

This program will review the concepts associated with the continuum of care in the new world of Accountable Care Organizations, value-based purchasing and bundled payments. In addition, we will review how to engage other members of the interdisciplinary care team in the process of planning for the patient’s movement across the continuum including verbal and written hand-off communication. Transitional planning is no longer a destination but a process!  Learn how to be certain that your processes address the complexities of the new healthcare environment.  Ensure your alignment with your post-acute care providers.

Learning Objectives:-

• Understand transitional planning as a process not an outcome
• Review the continuum of care and the elements that most greatly impact on patient transitions. 
• Identify best strategies to transition patients across the continuum of care, including how to align with those case managers in the post-acute care level of care

Course Outline:-

• Transitional planning as a process
• The Continuum of care and what it means
• Aligning best practices across the continuum
• Transition challenges and barriers
• Value-based purchasing and transitions
• Strategies for managing transitions
• Case management’s role in transitions

Why You Should Attend?

As case management professionals we need to understand the best practice processes for managing our patient transitions through the continuum of care.  We can no longer consider our job done when the patient leaves the hospital but must consider how they will manage at the next level of care and beyond. This requires a thorough understanding of the pitfalls and gaps in care that can occur each time a patient transitions from one level of care to another.  Are you up-to-date on what CMS is testing and has implemented in order to move healthcare toward a more continuum of care focus? This program will tell you what has changed and what you can do about it!

Who Should Attend?

• RN Case Managers
• Social Workers
• Directors of Case Management
• Directors of Social Work
• Post-Acute Care Providers
• Home Care
• Physician Advisors
• Directors of Finance
• Hospitalists