Hospital to Home
Reducing Hospital Readmissions
Ready-Set-Go Home is a transitional care program that is designed to help seniors make a successful transition home after hospitalization. This program includes a three-prong approach for reducing hospital readmissions: a major risk for seniors in the month after a hospital discharge.
Among seniors on Medicare, roughly 20% of discharged patients end up back in the hospital within 30 days of being sent home. Elderly adults have a much lower chance of recovery if they are re-hospitalized in this 30-day window, which is why reducing hospital readmissions is so important.
Specialized Nursing Services is committed to reducing hospital readmissions through our Ready-Set-Go Home program. Ready-Set-Go Home provides care recipients with skilled, non-medical home care during the period following a hospital discharge. We’ll help you coordinate your loved one’s transition home, assist your loved one during this transition, and support your loved one through their first weeks home from the hospital.
- At the Hospital. Our Ready-Set-Go Home program starts during your loved one’s hospitalization. Our caregivers can visit your loved one at the hospital and provide support services for family and friends. When doctors begin to discuss your loved one’s discharge, we can guide your family through the discharge process and provide valuable information on discharge planning. Our “Ready-Set-Go Home” guide includes detailed information on hospital discharges, questions you can ask doctors and nurses during this process, and tips on reducing hospital readmission risks.
- At the Client’s Home. After your loved one’s discharge, our caregivers will provide skilled, non-medical assistance to ensure your loved one’s safety and comfort during recovery. Meanwhile, we act as the “eyes and ears” in the home. Our caregivers can help spot changes in your loved one’s physical or cognitive health, and we know the reasons why many seniors skip follow-up doctors’ visits, miss medication doses, or otherwise fail to follow proper recovery protocols. If family and friends are acting as unpaid caregivers, our services can help them manage these responsibilities and avoid becoming overwhelmed.
- At the SNS Nursing Office. Behind the scenes, the Specialized Nursing Services office will support your family and your loved one’s caregivers. Our office has access to tools for reducing hospital readmissions by identifying clients at high risk of re-hospitalizing. Specialized Nursing Services staff can provide medication and appointment reminders, accompany your loved one to appointments, and help you coordinate medication, equipment, and food deliveries.
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Considering Your Options?
Try an Aide
We understand that choosing an aide to help with elder care services is a personal decision and can be intimidating. We would like to introduce our company and services by offering four hours of Private Duty Services. Our goal is to provide excellent elder home care and demonstrate how we can customize our care to your needs. We offer a complimentary, no-obligation demonstration of our Private Duty Services so that you can get to know us. Specialized Nursing Services provides an aide that will come to your home for four hours of care.