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healthcare-associated infections (hai) program

Interfacility Transfer Communications Guide

Communicating information about necessary infection control measures during each patient transfer can help prevent the spread of organisms between healthcare facilities. CDPH recommends all facilities use an interfacility transfer communication tool when transferring a patient to another facility, or incorporate the information into existing communication processes (for example, an electronic health record).

Facilities may use or adapt either form for patient transfers.

  • Interfacility Transfer Communication Form - Comprehensive (PDF)
    Use the Comprehensive form to track all information found on the Abbreviated form plus additional information relevant to infection prevention and antimicrobial stewardship, including patient symptoms, devices, antibiotic start and stop dates, and immunizations.

  • Interfacility Transfer Communication Form - Abbreviated (PDF)
    Use the Abbreviated form to communicate essential patient information, specific precautions, and evidence to support them. In addition to the form, also provide a copy of any lab results with antimicrobial susceptibilities.

The HAI Program strongly recommends communicating the information included in the Interfacility Transfer form by phone, in advance of transfer, for patients with the following high-priority multidrug-resistant organisms (MDRO):

What types of information is important to communicate?

  • ​Communicating key patient information prior to patient transfer helps ensure proper infection prevention and antibiotic stewardship measures are initiated or continued at the receiving facility. Facilities should communicate information regarding infection control precautions including isolation, patient symptoms, devices in use, antibiotic start and stop dates, and immunization status.

​Why should my facility use or adapt an interfacility transfer communication tool?

  • ​An interfacility transfer tool can help standardize the information that is communicated, and ensures the infection information is prominent and readily accessible immediately upon arrival at the receiving facility. Facilities may use or adapt the CDPH forms or incorporate the information into existing communication processes (for example, an electronic health record).

​How can healthcare facilities use the CDPH interfacility communication transfer forms?

  • Your facility may use either the Comprehensive or Abbreviated form as is, adapt either form to your facility needs, or incorporate elements from the forms into facility’s existing transfer communication process (for example, electronic health record). It is important for all the information listed on the transfer forms be communicated to the receiving facility; using a transfer form can help with this process, but the form itself is not required.

Who is responsible for the interfacility communication process and making sure information is received at the receiving facility?

  • ​Each facility should identify staff to be responsible for the transfer communication process and train them on how to use and incorporate the transfer communication process into facility procedures. Staff responsible may include case managers. These staff should also, upon transfer, document that all necessary information was communicated and received.
  • Staff responsible for the transfer communication process should establish relationships with infection prevention and case management staff at healthcare facilities within their referral network.

​I use an interfacility transfer tool at my facility, but I never receive them when patients are transferred to my facility. What should I do?

  • ​Facilities can request the information directly from contacts at the transferring facility. The transferring facility may or may not use the above interfacility communication tools, but they should be able to send all the requested information. Send the transferring facility a blank copy to fill out, if needed.
  • Contact your local health department (LHD) for assistance. LHD may set expectations for all local facilities to participate in the communication process.

​Contact Us

​The HAI Program provides consultative support to assist healthcare facilities and LHD with interfacility communication activities. Contact us at
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