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The first few days and weeks after a patient goes home from the hospital can be confusing and overwhelming, for not only the patient but their family members and/or caregivers as well.
Patients with a newly diagnosed chronic illness can be unaware that how they feel may be important signs and symptoms that their health is worsening, or what they eat may have a negative impact on their health. In addition, taking new medications and different combinations of prescribed medications can be confusing to patients who may not be aware of how the medications work together to affect their health and the illness.
St. Joseph’s Center for Transitional Care helps patients successfully get the medical care and information needed to successfully transition between leaving the hospital and managing their own care at home.
Before leaving the hospital, patients are visited by a clinical transition team member to explain the benefits of what our center offers by having medical care and services available soon after being released from the hospital. An appointment with a transitional care physician may be scheduled at the center before the patient is released from the hospital. The center is conveniently located on the campus of St. Joseph’s Hospital and Medical Center; servicing patients that need immediate follow-up care, especially those that may not have an established primary care provider. Our transitional care team includes a physician, nurse practitioners, a pharmacist and medical assistants.
Our transitional care team will work with a patient or their caregiver to set up a remote care monitoring system in their home as needed. The system includes written instructions and a checklist to follow. Patients may also receive a scale and blood pressure cuff with instructions on how often to record their health data and report it to the center. Remote Care Monitoring for patients provides an extra layer of care and important information about the patient’s health between appointments. Generally, a patient is under the care of our transitional care team for 30-45 days. Our transitional care team will communicate with a patient’s existing primary care provider, or can help patients find a permanent primary care provider if needed.
For more information or to schedule an appointment, call Dignity Health Medical Group St. Joseph’s Center for Transitional Care at 602.406.1140.
Dignity Health Medical Group
St. Joseph’s Center for Transitional Care
500 W. Thomas Rd. Ste 600
Phoenix, AZ 85013
Details & Directions: Dignity Health Medical Group Transitional Care - Chandler Regional