Medicine Transfer Request Guidelines

Medicine Transfer Request Guidelines: - Transfers are appropriate for patients with ongoing medical needs that require ongoing inpatient care but whose surgical issues have been resolved or become secondary to their medical requirements. - Requests for transfer on floor patients are never urgent but an urgent consultation can be requested for an acutely ill patient. - The Consult attending may need to directly communicate with the requesting service attending or chief resident. - Transfers based on difficult disposition should, in general, be strictly avoided. Services should be encouraged to refer to DHM long-term services (Magnolia/CARES) through the usual process if appropriate for q72 hour care. - If a transfer to medicine is felt to be most appropriate, the consult team will discuss patient with MAO and accepting medicine service. - If accepted, a team should be assigned and the patient transferred within 24 hours. - If the transfer request is accepted, an updated Hospital Course including any recommendations of the primary service and consulting services is required. - Medicine Consult will arrange for continued follow-up by the requesting service (if required). The MCS will communicate the need for consultative services to the requesting and the appropriate consulting team/pager will be identified in the transfer note. - When transferring patients/interacting with other services, please remember the Golden Rule: “Interact with your colleagues as you would like them to interact with you.” For OSH hospital transfers to other services requesting medicine transfer: Non-medical services often request medicine transfer for patients who were accepted as transfers from an OSH but do not require quaternary care in their specialty (often surgical). These are general rules to follow. For transfers accepted from OSH by a non-medical specialty service: - Ongoing specialty issues or complications – Remain on primary service with medicine consult as required. - No specialty quaternary needs but medical issues that continue to require quaternary care – Transfer to appropriate medical service. - No quaternary surgical or medical issues – Accepting service should seek back transfer. They should escalate to Associate CMO for Operations (Downs) if OSH refuses. If unable to back transfer, care should be discussed between attendings to determine most appropriate service on individual basis.

For surgical team transfer requests: Surgical teams often request medicine transfer for patients who “no longer have surgical needs.” For OSH transfers, please use rules as above. These are general rules to follow. - Acute surgical issues or post-surgical complications – Remain on primary service with medicine consult as required. - Surgical issues/complicated resolved and medical issues that continue to require hospitalization – Transfer to appropriate medical service. - No ongoing need for hospitalization – Remain on primary service. Primary service may refer to DHM long term care services (Magnolia/CARES) per usual process if stable for q72 care.