Interfacility Transfers

Patient transfers from one facility to another can occur for a number of reasons. Care may need to escalate (e.g., transfer to a tertiary care facility) or shift to an alternate level of care (e.g., transfer to a rehabilitation or long-term care facility). 

Computers do not transfer patients. It is always important to establish shared understanding between sending and receiving teams about what is about to happen and who bears what responsibility. 

Leave or Transfer?

When to Involve RAAPID

The RAAPID service manages all consultation requests within Connect Care. It should be used for transfers to a higher or lower level of care (including repatriations), and for transfers to emergency care. For more information, including workflows specific to ED and specialties, see the RAAPID Services section of this Manual.

Admission or Transfer?

Either or both of the sending and receiving sites may use Connect Care as the record of care. 

Connect Care or non-Connect Care Facility?

Until Connect Care has fully deployed throughout Alberta, there may be uncertainty about which facilities and sites are using Connect Care as their record of care and which are using different systems. The Connect Care facility list grows with each Connect Care launch. The following two resources can help clinicians determine which transfer workflows to use. Clinicians' awareness of facility information system status should be refreshed with each new Connect Care launch.

Interfacility Transfers from Non-Connect Care Sites

Interfacility transfers (IFTs) from sites where Connect Care is not the record of care follow their usual processes. This involves a RAAPID call requesting consultation and possible transfer to a higher level of care. If a transfer is approved, the sending site prepares transfer documents and transport orders in their legacy systems (e.g., paper).

Interfacility Transfers from Connect Care Sites

All IFTs from a site where Connect Care is the record of care are managed with an "Interfacility Transfer" navigator, found as a single tab within the "Discharge" activity available when a patient's chart is opened to an inpatient encounter. The navigator contains instructions. It is important to note different paths within the navigator according to whether the patient is going to a Connect Care site or a non-Connect Care site. 

Interfacility Transfer from Connect Care to Connect Care Site (click to expand/collapse)

Since the receiving facility is on Connect Care, there is no need for printed documentation. All the IFT navigator work will be visible to and used by the receiving facility. There are some minor workflow differences if transfers are initiated from the emergency department of one site (e.g., Wave 2 site) for receipt at a higher level of care (e.g., Wave 1 site).

Interfacility Transfer from Connect Care to non-Connect Care Site (click to expand/collapse)

The main difference for transfers to sites not using Connect Care is that orders and other care advice needs to be communicated as part of printed or faxed transfer documentation. 

There are two options within the navigator:

Interfacility Transfer Orders (Non Connect Care)

IFT to Out of Province Acute Care

Since the receiving facility is not on Connect Care, instructions and transfer orders must be printed. Clinical support staff use a variant of the Interfacility Transfer navigator to generate printed documentation that will accompany the patient. There are some minor differences if transfers are initiated from emergency at a Connect Care site.

Interfacility Transfer from Connect Care ED to Connect Care Admitting Site (click to expand/collapse)

Some AHS facilities have an emergency department (ED) service but no inpatient beds. A partnered (usually rural) facility has inpatient beds and the ED prescriber may be admitting a patient from the first ED to the receiving second facility. Indeed, the prescriber may have cross-covering responsibilities at the second site. 

Such workflows should be handled like an Interfacility Transfer from one Connect Care site to another for direct admit.

Interfacility Transfer from Connect Care to Continuing Care Site (click to expand/collapse)

Interfacility transfer of a patient to a Continuing Care facility (e.g., Long-Term Care, Designated Supportive Living, post-acute, hospice) has some slight differences from other IFTs. This is because Continuing Care facilities require different information at different times than other acute care sites. Every transfer to LTC/Continuing Care is an IFT, even if the LTC/Continuing Care is located in the same building. The processes described above apply, according to whether the continuing care site is on Connect Care. There are some additional considerations.

For more information on IFT to Continuing Care workflows, see the below resources: