Making hospital transitions safer during the pandemic

Care providers can take action to make hospital and emergency room transfers safer for residents during the coronavirus pandemic, according to a group of eldercare experts.

These experts have published a comprehensive guideline on safe and effective transitions that includes the following checklist points (summarized):

  • Medically stable patients who are appropriately isolated should not be transferred to the emergency department. Multidisciplinary teamwork can support providing care in place.
  • Address advance care planning with every patient and family in the context of COVID-19.
  • Carefully weigh the risks and benefits of transferring residents with a febrile respiratory illness to an emergency department. This includes an evaluation of the patient’s current state of health, patient-centered goals, and an assessment of prognosis in the context of COVID-19 illness.
  • Consider “forward triage” when considering patients for care transitions. This involves assessing the resident’s level of acuity. This should involve a conversation with the receiving emergency department physician.
  • Warm hand-offs are critical. Nursing home and emergency department providers need to communicate prior to a transfer and as medical decisions are being made, including the ability of the nursing home to safely accept a returning resident.

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