Emergency Department Transfer Communication

This measure for hospitals to evaluate communication for transitions of care during emergency department (ED) transfers 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 Federal Office of Rural Health Policy’s (FORHP) Medicare Rural Hospital Flexibility (Flex) Program.

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 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. The emergency department transfer communication (EDTC) measure allows the acute care safety net facilities to show how well they carry out their important stabilize-and-transfer role for rural residents.

The EDTC measure 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.

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 took effect starting January 2020 and are reflected in the resources below.