Transitions of Care


The greatest risk of variances in Patient Safety occur during times of transfer. The Emergency Department Transfer Communication measures were put in place to promote adequate communication among entity caregivers. For each patient transferring to another acute care facility, the transferring facility is required to have a mechanism to report essential communication to the receiving facility. A Memorandum of Transfer (MOT) contains many of these essential elements but additional elements should be added to the MOT to further advance patient safety and meet the intent of the MBQIP EDTC Measures.


• Memorandum of Transfer document with all measures defined (See Appendix A for MOT)
• Use of checklist or Stop in Transfer process as an alternative (See Appendix B, Emergency Department Care Transition Checklist)
• Include 2 signatures on all forms to promote teamwork in helping to ensure compliance
• Develop process for daily review of completed forms


• EHR prompts with all elements documented

Memorandum of Understanding Revisited

This example shows the MOT containing all the required elements of EDTC. It is helpful when using this tool to have a second person verify all the information is complete. The report should then be given to the receiving department.


If you choose not to use the MOT with EDTC elements imbedded you may opt to use this sample Care Transition Checklist. This sample checklist should be used by frontline, direct-care nursing to track inclusion of the essential elements of EDTC to help ensure safe and effective communication.

Appendix B



Karen Kendrick, director of clinical initiatives and quality, 512/465-1091


The resources included in the toolkits are offered as examples and do not constitute expressed or implied endorsement by the Texas Hospital Association Foundation.