Transitional Care

We provide transitional care to high-risk patients for the first 30 days after discharge in order to prevent costly hospital readmission’s and promote maximum patient knowledge and independence.

Transitional care promotes a nurse-patient relationship through home visits and follow up phone calls. Transitional care nurses apply what is known as “nurse coaching” by educating and reassessing patient knowledge regarding medications, discharge instructions, and available community resources. Through providing transitional care, Nursing Liaisons has proven to decrease hospital readmission’s and improve patient outcomes.