The role of nurses in Transitional Care is an innovative topic in the healthcare arena. According to the Agency for Healthcare Research and Quality (AHRQ) more than one-third of Medicare beneficiaries who are discharged from a hospital are re-hospitalized within 90 days and most of these are preventable. This indicates a need to improve coordination of post-discharge care. Health Care Reform’s Patient Protection and Affordable Care Act Section 3026:
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