Matheny’s transition nurse program is designed to assist our patients requiring services in other medical settings, both inpatient and outpatient. They understand the needs of our medically fragile patients and make daily visits to acute care settings to provide vital patient-specific information. The result: a smooth transition into and out of these settings, including all ambulatory care visits, too.
The goals of transition nursing are:
• Reduced hospital readmissions within 30 days.
• Increased patient, family and caregiver satisfaction.
• Accurate medication reconciliation.
• Improved communication across healthcare settings.