what is "transitional care"?

[mattj]

I am a nurse under 5 years. My practice has been limited to LTC, agency perdiem, & home care. Tomorrow I have an interview is a suburban hospital on a transitional care unit. My first instinct was to think transitional care referred to stepdown from ccu or surgery. Can someone define transitional care for me? Thank you, Matt

[somedaypeds]

I googled it. Sounds like rehab to me.

[MunoRN, RN]

I don't think it's all that strictly defined. I know of two "Transitional Care Units". One is an observation unit (gets patients out of the ER faster and into a unit where they can be coded as "inpatient" or "observation" patient faster, although it doesn't really get them "out" of the ER faster since it's essentially part of the ER). The other is an inpatient rehab unit.

[mappers]

Where I worked transitional care was a step-down from ICU.

[SaoirseRN]

My hospital has a transitional care unit, and it's used as either a sub-acute unit for when people no longer require acute medical care but may need some additional rehab before they can return home, or for patients who are waiting/wait-listed to go to a long term care facility.

[maryray]

Transitional care is included in the affordable care act. A transitional care nurse is a nurse case manager of patients who have comorbidities, chronic illnesses, or repeat hospital admissions. The nurse oversees the patient from hospital stay to a month or two post discharge collaborating with physicians, home health, family, and others for the best outcome of the patient and to prevent unnecessary re-admissions.