Due to some recent events, we are re-evaluating the procedure for hospital-to-hospital transfers.

Currently, the procedure is to discharge/readmit the patient to the new facility (rather than "transfer"). This comes with 2 main issues that we have identified:

1. Although orders may be re-ordered from the previous discharge facility, they only include medications and potentially an incomplete list of orders. Safety banners and nursing orders that are tied to diagnoses or previous drugs administered (e.g., systemic thrombolytics) do not follow the patient.

2. Orders (including nursing orders like "no anticoagulant" orders) MAY create alerts in the new admitted facility for up to ~2 hours post discharge without having been evaluated by a prescriber and not actively show up in orders in the new facility (it is triggering from the previous discharge facility).

Does anyone have example processes or builds that can help improve safety of these transitions of care?

Thank you!
molly.lassiter@balladhealth.org