The DON’s Guide to Preventing Unnecessary Hospital Transfers
- Bilquis Ali
- Sep 30
- 2 min read
If you’ve taken my Hospital Transfer Course or used my Hospital Prevention Tool, you already know how I feel about sending residents out.
The goal is always to prevent unnecessary hospital transfers when it’s safe and appropriate to manage residents in-house.
That doesn’t mean you’ll never transfer — falls with injuries, severe respiratory distress, or cardiac events are non-negotiable.
But too often, nursing home hospitalizations happen because the right processes weren’t in place.
Why Preventing Hospital Transfers Matters
Every time a resident is sent to the hospital, you risk more than just their stability. Transfers disrupt continuity of care, increase infection risk, and add stress to your team.
And let’s be real — there is nothing more frustrating than a resident transferred to the hospital… only to return within hours.
What does that tell me? It tells me we didn’t complete a strong change in condition assessment and didn’t provide background information when we notified the doctor.
Now, there will be times when the resident or family insists on a transfer — and that’s okay.
But the reality is, we need to avoid unnecessary transfers whenever possible and trust our team’s clinical capability to manage residents in-house.
How to Reduce Unnecessary Hospital Transfers
Morning Clinical & Stand Down Meetings: Daily huddles help identify subtle changes in condition early and prevent small issues from becoming big ones.
SBAR or Change in Condition Tools: Depending on what your facility uses, nurses should never call with “something happened.” They need an SBAR assessment: clear findings, vital signs, and background information so physicians can make informed decisions.
Ongoing Nurse Education: Your team needs to know what conditions can be managed in-house. The more you train and coach them, the fewer panic-driven transfers you’ll see.
QI Review After Every Hospitalization: Ask one simple question after each transfer: Could this have been prevented? Use that review to strengthen tomorrow’s process.
The Bottom Line for DONs
Hospital transfer prevention is about leadership, education, and follow-through.
Transfers will always happen, but they don’t have to happen as often. When you educate your team, lead stand downs, and make SBAR reporting non-negotiable, you reduce unnecessary hospitalizations and improve your facility’s outcomes.
👉 If you’re ready to reduce hospital transfers, improve nursing home quality measures, and lead with clarity, join my DON Training Program. Live calls with me, real tools you can use tomorrow, and the structure you need to stop running in circles.
As always, lead with love
❤️Bilquis Ali — YourFavNurseLeader
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