By Chris Adams

Dr. Alicia Arbaje studies the emerging field of transitional care, documenting the increased risk that comes when people move from facility to facility – each of which have the potential to introduce errors or infection.

Arbaje, an assistant professor of medicine at the Johns Hopkins University School of Medicine, told National Press Foundation fellows about the scattershot approach to health care – and how it can boost the risk for patients.

She detailed a year in the life of Walter, a 79-year-old widower who lives alone on a small pension and has five chronic conditions and eight medications to manage. In one year, he had been seen by eight physicians, six social workers, five physical therapists, four occupational therapists and 37 nurses. He does have a daughter nearby, and she helps manage his care – but she also has other work and family needs.

Arbaje detailed her research from Hopkins on the transitions from one care setting to another. She showed how those transitions are a prime place for medical errors and breakdowns in communication. Research from Hopkins in 2016 documented that medical errors are now the nation’s third-leading cause of death.

Arbaje’s own research has found a mismatch between where older people live in the U.S. and where hospitals have the kind of services that could provide a seamless continuum of care for those older patients. (Click for abstract and details on that research.)

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