Provider Resources
Transitions of Care Checklist
National Transitions of Care Coalition
This six-page checklist provides a list of important concepts, followed by a list of common elements for assessment and interventions. It includes an example of checklist and tool, and a glossary.
Handoff Communications
Association of periOperative Registered Nurses (AORN)
This nine-page document collates a selection of forms to record handover information as provided by several organizations.
Inpatient Paper Handoff Report
Northwestern Memorial Hospital, Illinois
This two-page document is a handover tool to effectively record diagnosis and post-procedure reports.
Tickets to Ride
These can be used to effectively record patient transportation within the hospital.
Doctors Hospital, Florida
Ticket to Ride
Salem Hospital, Oregon
Ticket to Ride
Comic Strip on Transitions of Care
Evergreen Hospital Medical Center
This is a novel idea introduced by Evergreen hospital to educate their clinicians internally on care transitions. The comic strip is accompanied by a supporting FAQ document.
Communicating with Patients and Families for a Smooth, Safe Hospital Discharge
Consumers Advancing Patient Safety
This two-page document provides guidance to clinicians to effectively communicate with patients and their families when preparing for hospital discharge.
Hospital Discharge “Take-Off” Process
Care Transitions Project of Whatcom County (Washington State)
The two-page hospital discharge checklist includes elements related to patient information, red-flags, medicines, and follow-up care.
Discharge Criteria
Home Health Quality Improvement National Campaign
This two-page document includes important discharge criteria such as review of items for acceptable discharge; discussion of important patient elements; review of high risk items and any other patient issues. It also includes a discharge face sheet to record supporting documentation in a tabular format.
Medication Reconciliation Elements
National Transitions of Care Coalition
This three- page medication reconciliation document includes medication assessment when care is sought in a healthcare setting, medication assessment on transfer of care, and other important elements for consideration.
Medication Discrepancy Tool
The Care Transitions Program
This one- page document is a tool for medication reconciliation at patient and system level, and provides a list of items to resolve medication discrepancies.