Sixty Plus Senior Care Transition - Piedmont Hospital

The program goal is to establish hospital and community partner interventions/processes to ensure safe and effective transitions for older adult patients and their caregivers, as they travel across the healthcare continuum and to home. The Transitions for Seniors Demonstration Project will design and implement an effective program to reduce hospital readmissions and unnecessary emergency room encounters, as well as improve the health care delivery system for older adults and their families by ensuring smooth transitions between healthcare settings and home.