title: Improving care transitions in individuals frequently admitted to the hospital.
authors.affiliation: Internal Medicine Research Unit, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia; School of Medicine, University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Alison M
authors.initials: AM
authors.lastname: Mudge
authors.forename: Michael
authors.initials: M
authors.lastname: Barras
authors.forename: Julie
authors.initials: J
authors.lastname: Adsett
authors.forename: Robert W
authors.initials: RW
authors.lastname: Mullins
authors.forename: Sophie
authors.initials: S
authors.lastname: Lloyd
authors.forename: Karen
authors.initials: K
authors.lastname: Kasper
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D003266:Continuity of Patient Care; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D010348:Patient Care Team; D057240:Patient Preference; D017060:Patient Satisfaction; D010865:Pilot Projects; D015397:Program Evaluation; D011795:Surveys and Questionnaires