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Hospital to PostAcute Care Transfer Form A. Patient Information V e r s i o n 4 .0 Too l B. Family/Caregiver/ Proxy Contact Name Family/Caregiver Name DOB / / Tel ( ) Gender: M F Language: English.

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How to fill out the INTERACT Version 4.0 Tools online

Navigating the INTERACT Version 4.0 Tools form is essential for effective patient transfer documentation. This guide provides users with clear, step-by-step instructions to ensure accurate completion of the form online.

Follow the steps to complete the INTERACT Version 4.0 Tools form online

  1. Click the ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin with section A, where you will input patient information. Fill in the name, date of birth, contact number, gender, and preferred language. Ensure all fields are completed accurately.
  3. In section B, provide family or caregiver contact details. List the names, relationships, and contact information accurately to maintain effective communication.
  4. Proceed to section C to address advance directives and goals of care. Indicate the patient's code status and document any specific instructions regarding their care preferences.
  5. Fill out section D with transferring hospital information, including the name of the hospital, unit, discharging nurse, and physician details.
  6. In section E, document post-acute care information, detailing where the patient is transferred. Include if a nurse-to-nurse report was provided.
  7. For section F, include the primary care physician’s details and any specialists involved in the patient's care.
  8. Complete section G with key clinical information such as vital signs and mental status assessments, along with diagnoses.
  9. In section H, indicate any high-risk conditions and provide relevant information related to treatment and monitoring.
  10. Fill out section J regarding medications and allergies, ensuring to attach any necessary documentation.
  11. Complete section K, outlining nursing care needs, including physical and sensory functions.
  12. Address section L for critical transitional care information, summarizing high-priority needs, pending tests, and follow-up appointments.
  13. Lastly, in section M, check off all attached documents and notes that accompany the form for comprehensive record-keeping.
  14. Once all sections are completed, save changes, download, print, or share the form as necessary to facilitate patient care.

Start filling out the INTERACT Version 4.0 Tools form online today for efficient patient transfer documentation.

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Acute care is a level of health care in which a patient is treated for a brief but severe episode of illness, for conditions that are the result of disease or trauma, and during recovery from surgery.

INTERACT® is an acronym for “Interventions to Reduce Acute Care Transfers.” The interventions is a quality improvement program designed to improve the identification, evaluation, and communication about changes in resident status.

Long Term Care Hospitals (LTCHs) provide care to patients with medically complex problems.

INTERACT® is an acronym for “Interventions to Reduce Acute Care Transfers.” The interventions is a quality improvement program designed to improve the identification, evaluation, and communication about changes in resident status.

The following are considered acute care facilities: Hospital (General Acute Care as well as Psychiatric, Specialized and Rehabiltation Hospitals; and Long Term Acute Care or LTAC) Ambulatory Care Facility. Home Health Agency.

What is INTERACT? INTERACT® (Interventions to Reduce Acute Care Transfers) is a quality improvement program that focuses on the management of acute change in resident condition. It includes clinical and educational tools and strategies for use in every day practice in long-term care facilities.

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