Proposed checklist for interfacility transfer

	The benefit of this transfer outweighs transport-related risks to the patient (eg, transfer will result in a higher level of care or definitive management of the patient's pathology)
	An accepting institution and treating physician have been identified and have accepted the patient in transfer
	This is the optimal time for transfer Appropriate equipment and staff are available for transfer Any further delay would likely result in further deterioration Extreme environmental conditions such as weather extremes have been accounted for
	The patient has been stabilized to the extent possible to minimize any transport-related risks Cardiorespiratory status has been assessed and optimized Contingency plans for further deterioration have been discussed with the team
	Mode of transport and appropriate personnel have been determined and the appropriate services contacted (for example, ground versus flight, basic versus advanced life support)
	Consent is obtained from the patient or proxy regarding reason for transfer and risks involved
	Paperwork required for transport is completed in keeping with institutional and regional regulations
	Handoff is given to personnel responsible for interfacility transport
	Written handoff is sent to the receiving institution and includes: Hospital course/discharge summary Relevant testing results Digital copies of any imaging if available Pending testing or transitional issues
	Verbal handoff is given to the staff at the receiving institution at the time of transfer; this traditionally includes both nursing and physician handoff

Graphic 140079 Version 1.0

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Proposed checklist for interfacility transfer