Next Step in Care: Family Caregivers & Health Care Professionals Working Together

A Toolkit for Working with Family Caregivers


This toolkit is based on the "Change Package" developed for the Transitions in Care-Quality Improvement Collaborative, a United Hospital Fund-led project aimed at improving both patient care and patient, family, and staff satisfaction. The collaborative ran from March 2010 to June 2012. Like that project, this toolkit addresses one of health care’s most persistent challenges—transitions of chronically or seriously ill patients between health care settings.

The Basics

Early identification of family caregivers
Assessment of the family caregiver's needs for training and support


Medication reconciliation
Medication management

Discharge Planning

Identifying and eliminating gaps in care
Discussing discharge options with the family caregiver
Communicating with the next care setting

The Transition

Effective handoff communication with the next setting of care
Reviewing discharge instructions with the family caregiver

Closing the Communication Loop

Follow-up with the next setting of care
Follow-up with the family caregiver


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