The Transitional Care Model (TCM), which was pioneered at the NewCourtland Center, is being replicated in four health systems (Veterans Health Administration, Trinity Health, University of California San Francisco [UCSF] Health, and Providence Joseph Health-Swedish Health Services [Swedish]) to rigorously examining patient and cost outcomes. The TCM is an advanced practice registered nurse (APRN) led, team-based intervention developed at Penn and proven in multiple NINR/NIA funded randomized clinical trials (RCTs) to improve health outcomes and reduce costs of care for at risk older adults transitioning from hospital to home.
For more information , please click here: https://www.nursing.upenn.edu/ncth/mirror-tcm/
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