Transitions of care: the next major quality improvement challenge

This review and discussion outline domains and a research agenda leading to improvements in the quality of transitions of care between health‐care settings. Over the past two decades changes in health care financing have restructured the organization and delivery of health care. Health‐care plans and insurers have shifted to provision of health care in less expensive settings and growing concerns about the quality of health care have arisen – continuity may be lost, errors may occur, and patients may end up deeply dissatisfied. To improve the quality across the continuum of care, providers will need to reconceptualize from an intra‐organizational to an inter‐organizational viewpoint and will have to focus on transitions of care across settings. Services, such as case management, must effectively bridge gaps in the continuity of care. Improved measurement of outcomes, such as satisfaction with the transition, will be necessary.