What Exactly Is Transitional Care Management (TCM)?

You’ve either heard about or witnessed firsthand how patients who don’t receive enough post-acute care services frequently end up getting sick again and/or needing to be readmitted.

The transitional phase between the inpatient and community environment is addressed by transitional care management (TCM). The patient may be dealing with a medical emergency, a new diagnosis, or a change in medication management following a hospitalization or other inpatient facility stay (such as in a skilled nursing facility).

Many chronic illnesses, including dementia, heart disease, COPD, diabetes, and others, can be handled in the patient’s neighborhood. But when there is a break in care when the patient is being moved from inpatient to at-home care, it can raise the likelihood of readmission and put the patient at risk for relapse. TCM is available to guarantee continuity of care throughout this transition.

TCM is intended to be used for 30 days. The fundamental principle of TCM is that a healthcare professional assumes control of the patient’s treatment as soon as the patient is released from the hospital. It entails a doctor seeing the patient in person once, followed by additional non-face-to-face consultations (such as by telephone or a video call, as is the case with telemedicine).

An essential component of tracking and controlling chronic illnesses is transitional care management. TCM aids in ensuring that patients’ needs are met as an increasing number of seniors seek to prolong their independent life.