Interhospital transfer handoff practices among US tertiary care centers

A descriptive survey

Dana J. Herrigel, Madeline Carroll, Christine Fanning, Michael B. Steinberg, Amay Parikh, Michael G Usher

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

BACKGROUND: Interhospital transfer is an understudied area within transitions of care. The process by which hospitals accept and transfer patients is not well described. National trends and best practices are unclear. OBJECTIVE: To describe the demographics of large transfer centers, to identify common handoff practices, and to describe challenges and notable innovations involving the interhospital transfer handoff process. DESIGN AND PARTICIPANTS: A convenience sample of 32 tertiary care centers in the United States was studied. Respondents were typically transfer center directors surveyed by phone. MAIN MEASURES: Data regarding transfer center demographics, handoff communication practices, electronic infrastructure, and data sharing were obtained. RESULTS: The median number of patients transferred each month per receiving institution was 700 (range, 250-2500); on average, 28% of these patients were transferred to an intensive care unit. Transfer protocols and practices varied by institution. Transfer center coordinators typically had a medical background (78%), and critical care-trained registered nurse was the most prevalent (38%). Common practices included: mandatory recorded 3-way physician-to-physician conversation (84%) and mandatory clinical status updates prior to patient arrival (81%). However, the timeline of clinical status updates was variable. Less frequent transfer practices included: electronic medical record (EMR) cross-talk availability and utilization (23%), real-time transfer center documentation accessibility in the EMR (32%), and referring center clinical documentation available prior to transport (29%). A number of innovative strategies to address challenges involving interhospital handoffs are reported. CONCLUSIONS: Interhospital transfer practices vary widely amongst tertiary care centers. Practices that lead to improved patient handoffs and reduced medical errors need additional prospective evaluation.

Original languageEnglish (US)
Pages (from-to)413-417
Number of pages5
JournalJournal of hospital medicine
Volume11
Issue number6
DOIs
StatePublished - Jun 1 2016

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Tertiary Care Centers
Patient Transfer
Electronic Health Records
Documentation
Demography
Physicians
Medical Errors
Information Dissemination
Critical Care
Practice Guidelines
Intensive Care Units
Nurses
Communication
Surveys and Questionnaires

Cite this

Interhospital transfer handoff practices among US tertiary care centers : A descriptive survey. / Herrigel, Dana J.; Carroll, Madeline; Fanning, Christine; Steinberg, Michael B.; Parikh, Amay; Usher, Michael G.

In: Journal of hospital medicine, Vol. 11, No. 6, 01.06.2016, p. 413-417.

Research output: Contribution to journalArticle

Herrigel, Dana J. ; Carroll, Madeline ; Fanning, Christine ; Steinberg, Michael B. ; Parikh, Amay ; Usher, Michael G. / Interhospital transfer handoff practices among US tertiary care centers : A descriptive survey. In: Journal of hospital medicine. 2016 ; Vol. 11, No. 6. pp. 413-417.
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