SHM Converge Scientific Abstract ePoster Gallery-Creation of a 'Round-Trip' Procedure-Only Interhospital Transfer Pathway

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The document describes the creation and evaluation of a “round-trip” procedure-only interhospital transfer pathway at Oregon Health & Science University (OHSU). This model was developed to help rural, critical access, and small community hospitals that lack tertiary procedural services and are facing long transfer delays due to pandemic-related strain, staffing shortages, and bed shortages.<br /><br />The pathway allows patients to be transferred to OHSU strictly for a specific procedure and then returned immediately to the referring hospital, rather than remaining admitted at the tertiary center. The team developed the workflow through more than five multidisciplinary meetings involving intake physicians, proceduralists, billing/coding, legal, anesthesiology, transfer center staff, and transport coordinators. Inclusion and exclusion criteria were defined for eligible patients.<br /><br />A retrospective review analyzed 49 procedure-only transfers from January 2021 through February 2023. Procedures included GI, interventional radiology, electrophysiology, and cardiology cases, such as ERCP/EUS, angiograms, pacer lead extractions, pacemaker placements, and IR drain placements. Most transfers came from one hospital system, and procedure volume increased over time.<br /><br />Compared with standard transfer pathways, the procedure-only pathway reduced the average time from transfer call to procedure from 3.39 days to 1.72 days. Time spent at OHSU fell from 13.6 days to 0.33 days, and inpatient length of stay dropped from 17.0 days to 7.38 days. Patients waited about half as long for procedures, and the model preserved at least seven inpatient nights per transfer. No patients required post-procedural admission at OHSU because of instability.<br /><br />The main challenges were legal and insurance contracting, transport reliability, and scheduling proceduralists. The authors conclude that the pathway is safe, improves access to procedures, and conserves tertiary care beds. Future goals include expanding contracts to more hospitals, reserving proceduralist time for these cases, and sharing the model with other institutions.

Asset Subtitle

Michael J. Hendricks

Meta Tag

Author List Asad Arastu, Katie Ellero, Marya Leahy, Matthias Merkel, Meaghan Schuette, Michael J. Hendricks, Stephanie Gilliam, Stephanie Halvorson

Category Innovations

Concept Pediatric Inter-Hospital Transfer

Concept Procedure

Concept Procedure-Only Pathway

Concept Time to Procedure

Concept Round-Trip Transfer

Distinguished Non-Finalist

Presenter Organization Oregon Health & Science University

Presenting Author Michael J. Hendricks

Track Transitions of Care

Keywords

interhospital transfer

procedure-only pathway

round-trip transfer

tertiary care access

rural hospitals

critical access hospitals

transfer delays

multidisciplinary workflow

length of stay reduction

OHSU

Pediatric Inter-Hospital Transfer

Procedure

Procedure-Only Pathway

Time to Procedure

Round-Trip Transfer