Quality improvement statement 8: Admission, discharge and transfer


Trusts have a multi-agency patient admission, discharge and transfer policy which gives clear, relevant guidance to local health and social care providers on the critical steps to take to minimise harm from infection.

What does this mean for patients and trust boards?

Patients with an infection can expect relevant information about it to be shared between providers when they are admitted, transferred to, or discharged from a hospital to ensure seamless care.

Boards lead on the development of an agreed multi-agency admission, discharge and transfer policy. They ensure mechanisms are in place to support and monitor adherence to the policy.

Evidence of achievement

1. Evidence of an admission, discharge and transfer policy for patients with an infection that has been agreed by all agencies involved in the patient's care pathway, including local community and public health teams.

2. Evidence that the agreed policy includes a risk assessment on admission, and for all transfers, to determine the presence or risk of acquiring or transmitting infection.

3. Evidence of a procedure for documenting and sharing information about infections and their treatment. This includes evidence of information sharing to manage and support patients with an infection on an ongoing basis (including transfer and isolation arrangements for them) during admission, transfer and discharge.

4. Evidence of clear advice being given to patients on antimicrobial prescribing for their ongoing care.

5. Evidence of clear advice being given to patients on the management of medical devices for their ongoing care.

Practical examples

  • Audit of adherence to relevant policy on admissions/transfers/discharges of patients with an HCAI.

  • Reduction in the number of adverse events recorded as a result of discharge and transfer of a patient with an infection.

Health and Social Care Act code of practice

Criterion 1: Guidance for compliance 1.1, 1.9, 1.10

Relevant national indicators

None identified.

  • National Institute for Health and Care Excellence (NICE)