What does "care transitions" really mean?

The phrase "care transitions" does not mean the same thing to consumers, providers, or policy makers. This article defines transitions and discusses transition models now in use and how one size does not fit all. It concludes with an exploration of the inter-professional team's role in effective transitions. The importance of communication across diverse disciplines is emphasized throughout, and the authors use a case study with multiple transitions to demonstrate the challenges many people, particularly those belonging to special populations, face in today's fractured healthcare system.