STAAR How-to Guide: Improving Transitions from the Hospital to Community Settings to Reduce Avoidable Rehospitalizations (NOTE: Login required)

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This How-to Guide is designed to support hospital-based teams and their community partners in co-designing and reliably implementing improved care processes to ensure that patients who have been discharged from the hospital have an ideal transition to the next setting of care (such as a primary care practice, home care, or a skilled nursing facility).