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Patient in a hospital bed in a transitional care unit

What is a transitional care unit?

Most people are familiar with the ER or ICU, but have you ever wondered where patients can go once they’re stable? One of the most important stages of hospital recovery occurs in the transitional care unit — also known as a step-down unit, intermediate care unit, or progressive care unit. Compared to the acute emergencies patients in ERs and ICUs experience, transitional care patients are in moderately critical conditions, requiring regular monitoring and organ support. Transitional care units provide treatment from a wide variety of healthcare professionals who assist in different parts of recovery. Here we will discuss each part of a transitional care unit that works together to facilitate healing.

How transitional care units fit into the hospital structure

Patients can recover more quickly and efficiently when the transition between hospital units is smooth and cohesive. Here are some of the main acute care units found in a hospital:

ICU: Intensive care unit

This is a specialized department for those who require intense critical care and close monitoring of high-acuity conditions. ICU patients come from a variety of places, including the emergency department, operating rooms, and general wards. Potential or current organ failure are the most common reasons for treatment in an ICU. This unit is staffed by nurses, intensivists, respiratory therapists, physical therapists, occupational therapists, and speech pathologists, among other specialists.

Step-down or transitional care unit

Once stabilized, patients are discharged from the ICU to transitional care units, or step-down units. The term “step-down” refers to the transition from one level of care to another. While those in transitional care units may still be critically ill, the transition is not determined by diagnosis, but by the level of care required from hospital staff. While medical needs are less acute than they are in the ICU, nurses in these units still monitor patients at bedside to identify any emergencies, while assisting with steady patient recovery. 

Medical surgical unit or general ward

Med-surg units contain those who are preparing for or recovering from surgery, and in some hospitals, general ward and med-surg units are combined. The number of persons in a med-surg unit is typically very large, with significantly fewer nurses. General wards contain a broader range of cases that are not specific to surgery.

Benefits of Transitional Care Units

Transitional care units provide a way for patients to remain in a stable condition and start making improvements. The benefits of spending time in this unit are long-term and crucial for complete recovery. Not only that, but hospitals are better able to function when there is a cohesive flow between units that reduces crowding and provides sufficient beds.

Hospital readmission is a common issue that medical centers face, since people are most at risk of returning immediately after discharge. While readmissions are always expected, hospitals can be penalized for an excessive amount of them.1 Repeated admissions constitute a financial burden on hospitals due to lack of beds and staff.2

The Society of Critical Care Medicine recently conducted a study on the impact of step-down units on patient outcomes after discharging from the ICU.3 Their findings concluded that admission to transitional care units resulted in fewer hospital readmissions for those with low-acuity needs.

These units have also been shown to improve patient outcomes by providing a continuum of care, improving the medical, functional, and psychosocial aspects of recovery. These services are administered by a variety of healthcare professionals who work together to address every aspect of patient health. A main focus of the unit is rehabilitation services — including physical, occupational, and speech therapies. This type of environment improves overall quality of life and decreases hospital mortality rates.

Types of patients found in transitional care units

Compared to those in life-threatening emergencies, individuals in transitional care units typically include those who are critically ill, yet stable. Some common conditions include severe infections, respiratory conditions, heart failure, stroke, complex chronic illnesses, and complex wounds and technology dependence. Here are more characteristics of patients you will find in these units:

Patients requiring multidisciplinary care

Transitional care unit patients often have multiple areas of concern and require the expertise of several healthcare professionals. For example, a person recovering from a stroke may be paralyzed, unable to swallow, and unable to speak. Healthcare specialists would work together to treat each issue.

Patients with complex medical conditions

Some found in these units may have medically complex conditions that must also be monitored and taken into consideration, along with the immediate issue. Conditions like Down syndrome, autism, rare illnesses, and physical traumas often require careful management and close monitoring.

Technology-dependent patients

These individuals benefit from a transitional care unit’s intensive monitoring and specialized respiratory therapy to reduce their dependence on these technologies. The multidisciplinary team works together to ensure a safe and effective weaning process, promoting recovery and improving their overall health.

Patients requiring rehabilitation services

Many of those in transitional care benefit from ongoing rehabilitation services to regain strength and cognitive functions. This includes physical, occupational, and speech therapy.

The Role of Nurses and Healthcare Professionals in Transitional Care Units

The role of nurses in transitional care units include patient monitoring, medication management, care coordination, and patient education. Physicians are responsible for overseeing patient care, monitoring vital signs, and assessing patient conditions. In addition to nurses and physicians, the following healthcare professionals are likely to administer treatment in these units:

  • Physical therapists
  • Occupational therapists
  • Speech-language pathologists
  • Nutritionists and dietitians
  • Respiratory therapists
  • Psychologists and psychiatrists
  • Wound care specialists
  • Clinical educators and trainers

Nexus Health Systems offers transitional care for acute conditions

At Nexus Health Systems, we offer several programs in transitional care units across the state of Texas. Our Harbor Program provides complex care for serious injury and chronic illness, while our Rise Program provides rehabilitation for those recovering from brain injury, spinal cord injury, and stroke. In addition to providing quality care for your loved ones, we offer caregiver training and a step-by-step plan for discharge. 

We’re here for the journey, and we’re ready to help. Contact one of our experts today.

  1. IPPS Hospital Readmission Reduction Program
  2. Readmission Rates and Their Impact on Hospital Financial Performance: A Study of Washington Hospitals
  3. The Impact of Step-Down Unit Care on Patient Outcomes After ICU Discharge
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