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Rural Emergency Department Transfer Communication
A National Quality Forum endorsed measure is available for hospitals to evaluate communication for transitions of care during emergency department (ED) transfers.
This ED transfer communication measure is particularly relevant for critical access hospitals (CAHs) and is included in the Medicare Beneficiary Quality Improvement Project (MBQIP). MBQIP is a program of the Health Resources and Services Administration (HRSA) funded Office of Rural Health Policy’s (ORHP) Medicare Rural Hospital Flexibility Program (Flex).
Appropriate measures are needed to evaluate care in rural hospitals
Nationally, all large hospitals are required to publicly report a set of core measures indicating their performance in providing quality care. Many of the publicly reported measures are not relevant to the low-volume of services provided by CAHs. Low volumes result in unreliable data, and some measures are for services not provided at CAHs.
While emergency care is important in all hospitals, the emergency department is particularly important in rural hospitals where the distance to urban tertiary care centers makes the effective triage, stabilization, and transfer of patients with the necessary and appropriate information of life or death importance. ED transfer communication measures allow the acute care safety net facilities to show how well they carry out their important stabilize-and-transfer role for rural residents.
The ED transfer communication measure (EDTC) was originally developed by Stratis Health and the University of Minnesota Rural Health Research Center in 2004 and was initially endorsed by the National Quality Forum in 2007. The University of Minnesota Rural Health Research Center has maintained the tri-annual endorsement of the measure through the National Quality Forum.
2018 technical expert panel review and revisions
In the spring of 2018, Stratis Health and the University of Minnesota Rural Health Research Center convened a national Technical Expert Panel (TEP) to review the measure and make recommendations to modernize and streamline the measure. Updates to the measure are currently under review through the National Quality Forum Endorsement process. Roll-out of the updated measure through the MBQIP program is anticipated in mid-2019.
Emergency Department Transfer Communication (EDTC) Measure (NQF #291), 2018 Technical Expert Panel Summary Brief: Background, Process, and Recommendations. (6-page PDF)
EDTC Brief: Provides the history and an overview of the Emergency Department Transfer Communication (EDTC) measure, as well as a summary of Medicare Beneficiary Quality Improvement Project (MBQIP) hospital reporting and improvement for EDTC for Quarter 1, 2015 through Quarter 3, 2016. (2017, 3-page PDF)
Emergency Department Transfer Communication - Special Innovation Project Final Summary Report Stratis Health led a one-year national special innovation project funded by the Centers for Medicare & Medicaid Services for critical access hospitals in eight states to improve transitions of care during ED transfers (August 2013 - July 2014). (2014, 15-page PDF)
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