SHM Converge Scientific Abstract ePoster Gallery-Context Matters: Outside Hospital Transfer Tool Assessment With Complexity Adjustment

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This study evaluated whether a standardized outside hospital (OSH) transfer communication tool improved outcomes for patients admitted to Department of Medicine services at a single academic medical center. The hospital implemented a required transfer note template to standardize physician handoffs, and prior analysis had shown that having any transfer note was associated with lower 24-hour and 30-day mortality compared with no note.<br /><br />To better account for patient illness severity, the authors cross-referenced 1,784 OSH transfers from April 2022 to March 2023 with Vizient data, successfully matching 88% of cases. They calculated adjusted outcomes using expected mortality and expected length of stay (LOS), including a novel 24-hour adjusted mortality metric. Length of stay index (LOSi) was also analyzed.<br /><br />Results showed that templated transfer notes were associated with significantly lower unadjusted 24-hour mortality (0.0% vs 1.3%) and significantly lower adjusted 24-hour mortality (0.0 vs 1.0). They also had significantly lower unadjusted 30-day mortality (6.1% vs 9.7%), although the adjusted 30-day mortality difference was not statistically significant (0.81 vs 1.0). There was no significant difference in LOSi (1.15 vs 1.19). Trends toward fewer rapid response team calls and codes within 24 hours were not significant, while telemetry upgrades were more frequent and ICU upgrades were not significantly different.<br /><br />Overall, the findings support the value of a standardized OSH transfer process in improving early mortality outcomes, even after accounting for patient complexity, but do not show a clear effect on length of stay.

Asset Subtitle

Kennedy E. Gallagher

Meta Tag

Author List Alan A. Kubey, Caitlin R. Vander Neut, Jeffrey M. Riggio, Kennedy E. Gallagher, Laura C. Miller

Category Research

Concept Patient Transfer Note

Concept Standardized Communication Process

Concept Outside-Hospital Transfer

Concept Patient Outcome

Concept Mortality

Distinguished Non-Finalist

Presenter Organization Sidney Kimmel Medical College at Thomas Jefferson University

Presenting Author Kennedy E. Gallagher

Track Quality Improvement

Keywords

outside hospital transfer

transfer note template

physician handoff

mortality outcomes

24-hour mortality

30-day mortality

length of stay index

patient transfer

standardized communication

academic medical center

Patient Transfer Note

Standardized Communication Process

Outside-Hospital Transfer

Patient Outcome

Mortality