NTOCC has created information to help healthcare professionals understand how poor transitions impact care delivery and how you can help improve transitions in your facility. Join NTOCC as an individual subscriber or ask for your company to join as an Associate Member to be notified as new tools become available.
Patient Bill of Rights During Transitions of Care
Transitions of care (or care transitions) take place each time a patient goes from one health care provider or health care setting to another. Problems often happen during these transitions because information is not communicated. Patients and their family have the right to care transitions that are safe and well coordinated. This guide can help patients get the information and services they need and deserve each step of the way.
Available Versions:
Full Patient Bill of Rights
Summary Patient Bill of Rights
My Medicine List
This is a list of important recommended information about a patient’s medications. The data elements indicate the prescriptions that patients have been prescribed and are currently taking along with information about their over-the-counter medications, vitamins, and nutritional supplements. The goal of the personal medicine list is to help patients improve their understanding of their current medicine regimens including why they need to take the medication and for how long.
Additional Languages:
Español / Spanish
Français / French
Taking Care of My Health Care
Taking Care of MY Health Care has been a much anticipated consumer tool. The tool was developed by the NTOCC Tools and Resources Work Group. It has been through numerous reviews with the group, by social workers, and a literacy review. The NTOCC Advisory Task Force approved it on September 16, 2008 at their meeting in Washington DC. This tool was developed as a guide for patients and their caregivers to use so they can be better prepared when they see a healthcare professional on what kind of information and questions they need to ask. NTOCC’s goal was to keep it simple; as a guide, to open the lines of communication and at the minimum to provide them with a convenient, simple format to have an updated list of their medication and what the next step in their care would be.
Additional Languages:
Español / Spanish
Français / French
Transitions of Care Checklist
This list provides a detailed description of effective patient transfer between practice settings. Implementing this process developed by NTOCC can help to ensure that patients and their critical medical information are transferred safely, timely, and efficiently.
How to Implement and Evaluate a Plan:
The Executive Summary outlines for you the concepts, process and how to use the guidebook titled Improving on Transitions of Care: How to Implement and Evaluate a Plan. In using the guidebook each transition point is treated as an exchange. Each exchange is where communication occurs and where evaluation may occur.
Improving Transitions of Care with Health Information Technology
NTOCC believes that for Health Information Technology (HIT) to make a difference in transitions of care, the technology must address several critical steps. The components include standardized processes, good communication, required performance measures, established accountability, and strong care coordination. Without addressing each step, the promise of HIT’s affect on overall transition of care improvement will not be realized.
Because there is little guidance on how to use HIT in ways that specifically improve transitions of care, this paper builds upon NTOCC’s overall recommendations for improving transitions of care and the national agenda as it relates to HIT, and identifies problems and considerations as they relate to NTOCC’s overall goals.
Issue Briefs: Improving Transitions of Care
This issue brief organizes the findings and considerations of the "Vision of the National Transitions of Care Coalition"
Cultural Competence: Essential Ingredient for Successful Transitions of Care
Health care professionals increasingly recognize the crucial role that culture plays in the health care of a client or patient and the need to deliver services in a culturally competent manner. Cultural competence is essential to successful, client-/patient-centered transitions of care. This tool provides information about culture and cultural competence, as well as strategies and resources to enhance professionals’ capacity to deliver culturally competent services during transitions of care.
Medication Reconciliation Essential Data Specifications
These consensus elements will help healthcare professionals collect, transmit and receive critical medication information needed when patients move from one practice setting or level of care to another. The use of these elements in the reconciliation process required by the Joint Commission could help reduce medication errors.
Transitions of Care Measures
At present, there is a large evidence base that demonstrates the existence of serious quality problems for patients undergoing transitions across sites of care. While currently there are transitions of care measures on the structure, process, and outcomes of care that are useful, measure gaps still exist. This report by the NTOCC Measures Work Group summarizes an environmental scan of existing measures that are applicable to care transitions and highlights the Work Group's recommendations. Included is the Care coordination Hub, a conceptual model defining seven key elements for effective transitions of care.
Included is the Care Coordination Hub, a conceptual model defining seven key elements for effective transitions of care.
Informational Slide Deck
Download this presentation to learn more about how transitions of care impact care delivery and how you and other professionals can use NTOCC tools to improve transitions.
Informational Brochure
This brochure contains easy to understand information about transitions of care that can help you in sharing and discussing this critical health care issue.
Policy Paper
This detailed concept paper outlines steps to be considered by the healthcare industry and policy makers to improve transition performance.