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View AllHealio interview with Dr. Michael Weiner
Michael Weiner, M.D., MPH, was interviewed by Healio about one...
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View AllPicking Up PrEP-Role of Clinician Specialty
Published in the journal JAMA Internal Medicine. Here is a...
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Regenstrief envisions a world where better information empowers people to end disease and realize true health.
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Transitional Care
Improving outcomes for our most vulnerable
The course of care for older adults often involves transitional care, moving from one healthcare setting and team of practitioners to another. Unfortunately, gaps in communication and access to needed services during these transitions can leave patients vulnerable to adverse events and greater chances of re-hospitalization.
Our goal in our research is to improve the outcomes for patients in transitional care, reduce avoidable hospitalizations, and improve the ease and efficiency with which patients and their caregivers move between care settings.
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Related News & Stories
New app to bridge information gap between hospitals and nursing homes
Prototype demonstrates improved data exchange, potential for better care for patients Approximately one in five older adults in the U.S. is transferred to a nursing home...
Drs. Boustani, Unroe and Glober: How interhospital transfers affect patients
Improving outcomes for our most vulnerable The course of care for older adults often involves transitional care, moving from one healthcare setting and team of practitioners…
Regenstrief research scientists participate in national conversation for advancement of aging research
Regenstrief Institute researchers are sharing the stage with other national aging research experts as they participate in the dissemination of scientific advances during the Gerontological Society...
Caregiver engagement enhances health outcomes of chronically ill adults
New meta-analysis of studies spanning three decades provides compelling evidence of caregivers’ value across healthcare transitions Led by Regenstrief Institute Research Scientist Kristin Levoy, PhD, MSN,...
Innovative tool targets avoidable hospitalizations of nursing home residents with existing nursing home EHR information
The Avoidable Transfer Scale, an innovative tool that uses data commonly included in a nursing home resident’s electronic medical record to identify and characterize potentially avoidable...
People returning home from skilled nursing facilities need tailored instructions
Research especially important as COVID-19 creates new challenges in care transitions Returning home after a stay in the hospital and a skilled nursing facility is often...
Nursing home residents with cognitive impairment more likely to be admitted to hospital
Study sheds light on transfers of care and ways to improve care for nursing home residents Transfers from the nursing home to the emergency department (ED)...
Caring for nursing home residents during COVID-19 pandemic
Regenstrief Institute research scientist and Indiana University School of Medicine faculty Kathleen Unroe, M.D. MHA, and her team have been instrumental in improving and guiding care...
Shaking up how nursing homes and their clinicians are paid to care for sick residents
Keeping frail older adults in a familiar place with staff and providers who know them is the aim of the ongoing second phase of OPTIMISTIC, an...
Diagnosis is not enough: Predicting avoidable transfers from nursing homes is complex
INDIANAPOLIS – Treating acutely ill nursing home residents in place and avoiding hospitalizations when possible is better for their health and for the healthcare system. Common...
How does it compare?: Hospice care at home, at assisted living facility, at nursing home
Use of hospice has exploded over the past decades with approximately half of those who die while enrolled in Medicare receiving hospice care. A new study...
Study compares hospice care in nursing homes, assisted living facilities and patient homes
INDIANAPOLIS — A new study from the Indiana University Center for Aging Research and the Regenstrief Institute has found only minimal differences in the intensity of...
Expanding throughout Indiana, OPTIMISTIC study tests new CMS payment model
INDIANAPOLIS — Indiana University’s OPTIMISTIC study has added an additional 25 facilities across Indiana as it expands its efforts to improve the health and health care...
Ensuring medical care is consistent with patient goals
INDIANAPOLIS – It can be challenging to determine whether the medical care provided in a hospital or nursing home is consistent with the preferences of the...
OPTIMISTIC study: Unique nurse practitioner role leads to safer care in nursing homes
INDIANAPOLIS – Transfers of nursing home residents to and from the hospital frequently expose these frail, older adults to medication errors and poor follow-up care resulting...
IU and Regenstrief’s OPTIMISTIC named one of 20 top geriatric studies of 21st century
INDIANAPOLIS – The OPTIMISTIC study, an innovative program developed and implemented by clinician-researchers from the IU Center for Aging Research at Regenstrief Institute to prevent unnecessary...
The right stuff? Hospital readmission penalties approaching for nursing home patients
March 31, 2016 INDIANAPOLIS — A significant number of older adults are not ready to go home when they leave the hospital. About one-fifth are discharged...