Implementation of Coordinated-Transitional Care Program

Implementation of Coordinated-Transitional Care Program

Implementation of Coordinated-Transitional Care Program 150 150 Peter

Implementation of Coordinated-Transitional Care Program

Review your problem or issue and the cultural assessment. Consider how the findings connect to your topic and intervention for your capstone change project. Write a list of three to five objectives for your proposed intervention. Below each objective, provide a one or two sentence rationale.

After writing your objectives, provide a rationale for how your proposed project and objectives advocate for autonomy and social justice for individuals and diverse populations

Sample Paper

Implementation of Coordinated-Transitional Care Program

Readmission in-hospital care is most common and exhibits patients to infections, increasing their length of stay while decreasing their quality of life. Although there is much knowledge associated with causes of readmission and the usefulness of preventive measures, readmission in hospital continue to plaque the healthcare organizations (Page 2018). Through the implementation of transitional care, readmission rates will go down. This paper discusses the objectives of implementing coordinated- transitional care and how they have advocated for autonomy and social justice for individuals and diverse populations.


The coordinated-transitional care program will be governed by the following three objectives, which will help reduce the readmission rates.

  1. Timely physician check-up.

Timely physician check-ups involve frequent medical examinations, including blood tests (Leonard et al., 2017). It will help the nurses to detect any disease outbreak and faster treatment of the disease.

  1. Patient-centeredness.

These will help to improve individuals’ health programs, and health providers will benefit by reducing expenses throughout care. Patient-centeredness will help the nurse practitioners in resource allocation.

  1. Education to patients.

Providing education to patients will help patients gain knowledge and understanding for their self-management. In addition, it will help the nurses inform the patients of the proper way to protect their health care and avoid unnecessary readmission.

Implementation of coordinated-transitional care

Implementing a coordinated-transitional care program will provide patients with more care and time in their homes and help them together with their families create long-term care. A coordinated-transitional care program will help nurses keep people safe and their health. It will involve honoring them and their choices and improving their living standards. Health care providers will be able to educate the patients but not be involved in patients’ decision-making.


The Transitional care program in hospitals and community settings will be important with few patients’ readmission. Implementing a coordinated-transitional care program will mentor providing support to medical facilities which need to implement coordinated-transitional care programs. In addition, the program will reduce health care costs, improve quality, and increase patient satisfaction. With the proposed intervention, readmission rates will slow down.



Leonard, C., Lawrence, E., McCreight, M., Lippmann, B., Kelley, L., Mayberry, A., … & Burke, R. (2017). Implementation and dissemination of a transition of care program for rural veterans: a controlled before and after study. Implementation Science12(1), 1-8.

Page, T. (2018). Implementing the Coordinated-Transitional Care Program to Reduce All Cause Readmissions.