The care transitions innovation (C-TraIn) for socioeconomically disadvantaged adults: results of a cluster randomized controlled trial

H Englander, L Michaels, B Chan… - Journal of general internal …, 2014 - Springer
Background Despite growing emphasis on transitional care to reduce costs and improve
quality, few studies have examined transitional care improvements in socioeconomically …

Planning and designing the care transitions innovation (C‐Train) for uninsured and Medicaid patients

H Englander, D Kansagara - Journal of hospital medicine, 2012 - Wiley Online Library
BACKGROUND: Uninsured and Medicaid patients are particularly vulnerable as they
transition from hospital to home. Transitional care improvement programs require time and …

Transitional Care Interventions From Hospital to Community to Reduce Health Care Use and Improve Patient Outcomes: A Systematic Review and Network Meta …

N Tyler, A Hodkinson, C Planner, I Angelakis… - JAMA Network …, 2023 - jamanetwork.com
Importance Discharge from the hospital to the community has been associated with serious
patient risks and excess service costs. Objective To evaluate the comparative effectiveness …

The importance of transitional care in achieving health reform

MD Naylor, LH Aiken, ET Kurtzman, DM Olds… - Health …, 2011 - healthaffairs.org
Under the Affordable Care Act of 2010, a variety of transitional care programs and services
have been established to improve quality and reduce costs. These programs help …

Systematic review of ambulatory transitional care management (TCM) visits on hospital 30-day readmission rates

KL Roper, J Ballard, W Rankin… - American Journal of …, 2017 - journals.sagepub.com
To reduce readmission rates and prevent adverse outcomes after discharge, hospitals have
begun implementing “transitional care” initiatives. This systematic review identifies research …

[HTML][HTML] Development and implementation of the Coordinated-Transitional Care (C-TraC) program

A Gilmore-Bykovskyi, L Jensen… - … of the VA, DoD, and PHS, 2014 - ncbi.nlm.nih.gov
The transition from hospital to home is increasingly recognized as a time of heightened risk
for vulnerable patients, particularly older adults. Poor-quality transitions have been …

[HTML][HTML] Effects of a transitional care practice for a vulnerable population: a pragmatic, randomized comparative effectiveness trial

DT Liss, RT Ackermann, A Cooper, EA Finch… - Journal of general …, 2019 - Springer
Background There is limited experimental evidence on transitional care interventions
beyond 30 days post-discharge and in vulnerable populations. Objective Evaluate effects of …

Short-term and long-term effectiveness of a post-hospital care transitions program in an older, medically complex population

PY Takahashi, JM Naessens, SM Peterson… - Healthcare, 2016 - Elsevier
Background Care transition programs can potentially reduce 30 day readmission; however,
the effect on long-term hospital readmissions is still unclear. Objective We compared short …

The care transitions intervention: translating from efficacy to effectiveness

R Voss, R Gardner, R Baier, K Butterfield… - Archives of internal …, 2011 - jamanetwork.com
Background Well-executed communication among hospital providers, patients, and
receiving providers at the time of hospital discharge contributes to better health outcomes …

Project ACHIEVE–using implementation research to guide the evaluation of transitional care effectiveness

J Li, J Brock, B Jack, B Mittman, M Naylor… - BMC health services …, 2016 - Springer
Background Poorly managed hospital discharges and care transitions between health care
facilities can cause poor outcomes for both patients and their caregivers. Unfortunately, the …