Recently, the National Transitions of Care Coalition (NTOCC), a non-profit founded by CMSA posted a Transitions of Care checklist which aids in identifying areas providers do not currently assess but may want to begin including in patient records moving forward. The main goal of the checklist is to increase communication between providers, care settings, and caregivers of patient care plans, assessment and other clinical information.

The checklist which can be found here is one of several free professional tools that NTOCC offers to help health care professionals.  The list includes the following Overarching Concepts:

• Engagement

• Collaboration

• Strengths-based assessment

• Assessment as an ongoing process 

In addition to the Overarching Concepts, the checklist also includes Common Elements for Assessment and Intervention:

• Physiological functioning

• Psychosocial functioning

• Cultural factors

• Health literacy and linguistic factors

• Financial factors

• Spiritual and religious functioning

• Physical and environmental safety

• Family and community support

• Assessment of medical issues

• Continuity/Coordination of Care Communication

This is one of several free professional tools for case managers offered by NTOCC.  Please visit NTOCC’s website to view all of the resources that they have to offer.