Jennifer Harris

Jennifer Harris, was shocked and delightfully surprised when her phone started ringing shortly after her discharge following her open-heart surgery at the start of the pandemic in March.

The Sun City resident lives alone and was nervous about the days ahead following her serious surgery.

“I’ve gotta say, I received the first call and it felt so good. I had received extraordinary care at the hospital and here you go home and you feel like a fledging, like, “oh no, what do I do now?” she recalls. “Then I received a call from a nurse from Sun Health saying I am going be keeping in touch with you and going over things. I am here for questions. It was such an extension of professionalism and the comfort of following me to my home was really appreciated.”

Sun Health’s Care Transitions is a 30-day program that includes a nursing assessment, chronic disease education, medication review and education, a home-safety evaluation, a fall-risk assessment and information on community resources, all provided during an in-home visit by a registered nurse within 48 to 72 hours after the patient has been discharged. Licensed practical nurses make weekly follow-up calls to check on the patient, reinforce education and confirm that doctor appointments have been made and kept. A social worker is available to assist patients who need extra support.

There is no cost to patients for the program. It is funded through a combination of Center for Medicare and Medicaid Services funding and support from Sun Health Foundation donors.

Jennifer says the comforting calls and outreach made a big difference in her recovery.

“It was so reassuring. I did have my son stay with me for a few days and he was a Godsend, but he was understandably tense and nervous,” Jennifer shares. “But having a professional nurse call to check on my weight, blood pressure and my eating, all the things I would get at the doctor’s office – It was a nice reassurance that I was still getting medically looked after even though I was home.”

To find out more on how the Sun Health Care Transitions team can assist you or a loved one following a hospital stay, please call 623-471-9595.