Challenges in arranging interhospital transfer from a non‐tertiary hospital emergency department in the Perth metropolitan area. (16th September 2014)

• Record Type: Journal Article
• Authors: Gillman, Lucia; Jacobs, Ian; Fatovich, Daniel M
• Is Part Of: Emergency medicine Australasia. Volume 26:Number 6(2014)
• Page Start: 567
• Page End: 572
• Publication Date: 2014-09-16
• Subjects: Emergency medicine -- Periodicals; Emergency medicine -- Australasia -- Periodicals; 616.025
• DOI: 10.1111/1742-6723.12299
• Languages: English
• ISSNs: 1742-6731

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="emm12299-sec-0001" sec-type="section"> <title>Objective</title> <p>To describe the organisational demands on staff when arranging interhospital transfers (IHTs) from an ED.</p> </sec> <sec id="emm12299-sec-0002" sec-type="section"> <title>Method</title> <p>Prospective observational study of IHTs from three non‐tertiary hospital EDs in the Perth metropolitan area. Data were collected over 14 consecutive days commencing 20 January, 26 March and 6 July 2010 for each respective site. Outcome measures were the time taken for transfer acceptance, the number of telephone calls required and the perceived degree of difficulty to arrange a transfer.</p> </sec> <sec id="emm12299-sec-0003" sec-type="section"> <title>Results</title> <p>We examined 229 (70%) of the 325 IHTs conducted during the study period. Transfers took 1–11 telephone calls to arrange (median 2). More calls were required for urgent (median 4, IQR 3.5–9.4, <italic>n</italic> = 69) than non‐urgent IHTs (median 3, IQR 2–4, <italic>n</italic> = 160, <italic>P</italic> = 0.04). Four or more calls were required in 23.5% of cases (<italic>n</italic> = 54) with 20 (9%) of these involving critically ill patients. The median time to transfer acceptance was similar for urgent (10 min, IQR 4–24, <italic>n</italic> = 69) and non‐urgent IHTs (10 min, IQR 5–23, <italic>P</italic> = 0.48, <italic>n</italic> = 155). A post‐hoc analysis describing IHTs that took over 1 h to organise, showed that urgent transfers took 155 min (IQR 132–213) compared with 120 min for non‐urgent IHTs (IQR 79–157; <italic>P</italic> = 0.07). Arranging an IHT was perceived to be challenging in 6% of cases with the clarity of decision‐making, receiving staff understanding of the limitations of referral hospital services and the effect of delays of prime importance.</p> </sec> <sec id="emm12299-sec-0004" sec-type="section"> <title>Conclusion</title> <p>While most IHTs are straightforward, critically ill transfers require considerable time, effort and teamwork to arrange.</p> </sec> </abstract>