Care Coordination & Transition Management (137)

The CCTM online course and core text will help nurses solve the puzzle of fragmented patient care. It is an evidence-based, patient centered program designed to:

  • Improve patient outcomes
  • Enhance access to quality care
  • Decrease hospital readmissions
  • Decrease health care costs
  • Help patients navigate the health care system
  • Ensure continuity and seamless transitions among levels and settings of care
  • Work effectively in Patient-Centered Medical Homes (PCMHs)and Accountable Care Organizations (ACOs)
  • Improve the individual patient’s experience of care

Contact hours available until 7/1/2024.

Please Note: 

Please Note: ANCC has determined it will not refresh the CCCTM exam. The credential will continue to be available for renewal only to nurses who already hold the credential. ANCC is exploring board certification(s) that align with population health needs for the future, and AAACN has been invited to explore in collaboration with ANCC.

For more information regarding CCCTM, visit the ANCC Website.

Please contact ANCC at certification@ana.org for more information about how to renew your certification through ANCC.

The course includes an audio presentation, slides, and a PDF version of the corresponding core text chapter. Nurses will read the chapter prior to viewing the audio presentation. The course provides 26.4 contact hours.

View Course

Additional sessions listed below fall into the category of care coordination and transition management, but are not part of our flagship course.


Care Coordination & Transition Management Products

Redesigning Care Delivery to Define the Ambulatory Care Nursing Role

Redesigning Care Delivery to Define the Ambulatory Care Nursing Role

Operationalizing the Role of the Protocol Coordinator in a Clinical Research Setting

Operationalizing the Role of the Protocol Coordinator in a Clinical Research Setting

Improving the Bottom Line: Seeing BSN-RNs in Primary Care as Value, not Just Cost

Improving the Bottom Line: Seeing BSN-RNs in Primary Care as Value, not Just Cost

Development and Validation of a Medical Home Model for Persons with Spinal Cord Injuries

Development and Validation of a Medical Home Model for Persons with Spinal Cord Injuries

Improved Quality and Staff Satisfaction through Telework

Improved Quality and Staff Satisfaction through Telework

Decreasing Admission Rates of Heart Failure Patients Using Newly Created Outpatient Clinical Pathway For Post-Hospital Follow-Up

Decreasing Admission Rates of Heart Failure Patients Using Newly Created Outpatient Clinical Pathway For Post-Hospital Follow-Up

Risky Business: One Health Care System's Model of Risk Stratification

Risky Business: One Health Care System's Model of Risk Stratification

May 10, 2019
Senior RN Ambulatory Care Manager and Health Guide Partnership: Mobile, High-Touch, High-Frequency Support Outside Clinic Walls

Senior RN Ambulatory Care Manager and Health Guide Partnership: Mobile, High-Touch, High-Frequency Support Outside Clinic Walls

May 10, 2019
Answering the Call to Action

Answering the Call to Action

May 10, 2019