The TARGET

Tool for Addressing Risk: a Geriatric Evaluation for Transitions: TARGET

The TARGET is a 4-part tool that includes:

1. Risk stratification process (the 7P tool).
2. Risk-specific intervention plan linked to the 7P risk score summary.
3. Universal set of expectations for all patients being discharged from the hospital to home (the Universal Checklist)
4. General Assessment of Preparedness (GAP), a component list of issues important to providers and patients (and their caregivers) surrounding the readiness of patients for transition out of the hospital.

Each of the elements of the TARGET are discussed individually. It should be noted that by its nature, the TARGET is a multidisciplinary tool. Elements may be assessed by different members of the inpatient care team (eg, nursing, case management, physicians, pharmacists, and social workers), and the tool can then act as a central repository of the information. The “Confirmed by” signature should be completed by whoever at the institution has final ownership of the transition process (e.g., the discharge planner or nurse).  Determining the individual (or preferably the role of the individual) who has ultimate ownership of the process is a critical step in improving the transition of care process.

View the TARGET tool