Transitional Care

The Transitional Care Center at University of Maryland Baltimore Washington Medical Center is an outpatient transitional health center led by a multidisciplinary team of medical professionals. The Center is dedicated to helping patients navigate the right care in the right setting.

It focuses on providing continuity of care by facilitating and coordinating communication between the health care team, the patient and their family. The Center integrates both internal and community-based relevant care services to achieve better health and better care for our community.

The Transitional Care Center's services include:

• Deliver care coordination to patients who frequently utilize the Emergency Department, have repeat observation or inpatient hospital readmissions, who have no primary care provider or have not had a primary care visit in the last 12 months.
• Connect patients with primary care providers, specialists and appropriate social services.
• Collaborate with the above providers for patient care planning and summary of Transitional Care Center visit.
• Provide support services for primary care practices who have patients with complicated care needs.
• Provide medication reconciliation, care planning and education regarding disease management.
• Offer intravenous diuretic therapy to patients with congestive heart failure (CHF) who experience symptoms of congestion.
• Maintain contact with patient and provide follow-up on outstanding medical tests, and additional appointments when necessary.

After you are discharged from your hospital stay, you may be referred to our Transitional Care Center for a follow-up visit. This will help you safely transition home, and receive support to stay healthy and maintain your best health.

The Transitional Care Center is located on UM BWMC's campus in the Aiello Center, Suite 312. To contact the Center, please call 410-787-4291.