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Improving Care Transitions Between the Nursing Facility and the Acute-Care Hospital Settings

This white paper, presented by the American Medical Directors Association (AMDA), is intended to recognise and emphasise the importance of efficient patient-centred processes, for transferring patients from acute-care hospital (ACH) to skilled nursing facilities (SNF/NF) and from SNF/NF to ACH, including the emergency department.

The primary focus of this white paper is to highlight the crucial factors in the care transition process and specify key features of a successful care transition process.

AMDA recommends the key elements to be taken into account to ensure a safe care transition process include patient-centred care, communication and safety.

The aim of this white paper is to guide policies and procedures which enhance communication and support safe, patient-centred care as patients and families transition between sites of care.

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