Transitional Care

Care transitions occur when patients move between different healthcare settings, such as from a hospital to home care or between different practitioners. Poorly executed transitions can harm patients and lead to unnecessary hospital visits. PCORI has funded comparative clinical effectiveness research studies and related projects that aim to help patients and their caregivers make better-informed decisions about their options for treating rare diseases.

Thirty transitional care projects composed the Transitional Care Evidence to Action Network (TC-E2AN), which was active between 2015 and 2021, to support and connect PCORI-funded research teams studying transitional care.

Study Results that Support Better-Informed Decisions


Supporting Parents’ Mental Health from NICU to Home

A PCORI-funded study — comparing a program with and without peer support for parents leaving the neonatal intensive care unit (NICU) for home — has led to improved mental health screenings and the formation of a mental health taskforce at Children's National Hospital in Washington, DC. Learn more from the researchers

Journal Spotlights Transitional Care Studies


Developments in Patient-Centered Transitional Care Research

A special August 2021 Medical Care supplement highlights findings, lessons, and challenges in conducting patient-centered research in transitional care. It features articles authored by 11 research teams, along with guest commentaries that provide reflection on past and future directions for the field. View the articles in the supplement

Addressing Transitional Care Challenges

The PCORI Approach to Transitional Care
Why Study Transitional Care?