SHM Converge Scientific Abstract ePoster Gallery-Hospital Medicine Provider Perspectives on Inter-Hospital Transfers

Pdf Summary

This qualitative study explored hospital medicine physicians’ and advanced practice providers’ experiences with inter-hospital transfers (IHTs) at a quaternary academic center. The motivation was that IHT patients have worse outcomes than patients admitted from the emergency department, including higher mortality, longer length of stay, and more adverse events, even after adjusting for case mix.<br /><br />Using 1-hour semi-structured interviews with 30 inpatient hospital medicine physicians and APPs, the researchers found wide variability in how IHT care is coordinated. Participants described several recurring challenges:<br /><br />- Fragmented communication during transfers, with multiple handoffs creating opportunities for information loss or error  <br />- Poor system-level knowledge of how IHT processes should work  <br />- High cognitive load and work pressure for clinicians managing these patients  <br />- Delays in care and inappropriate triage related to inconsistent transfer processes<br /><br />Providers emphasized that even when transfers occur as intended, each step adds risk, especially if a patient’s condition changes soon after arrival.<br /><br />The study identified three major solution themes:<br />1. Standardize handoff content, documentation, and the timing of status updates  <br />2. Create system-wide IHT guidelines and education for staff  <br />3. Improve clear interdisciplinary communication, including clearer roles and responsibility sharing<br /><br />The authors conclude that best practices for IHTs should include reliable and timely information transfer, consistent guidelines, and better communication across teams. They also suggest dedicating personnel specifically to coordinate IHT care rather than adding this responsibility to clinicians’ existing workload.

Asset Subtitle

Amy Yu

Meta Tag

Author List Amy Yu, Brooke Dorsey Holliman, Christine D. Jones, Claire Westcott, Lauren McBeth, Stephanie K. Mueller

Category Research

Concept Pediatric Inter-Hospital Transfer

Concept Care Coordination

Concept Patient Safety

Concept Information Transfer

Concept Communication Breakdown

Distinguished Non-Finalist

Presenter Organization University of Colorado

Presenting Author Amy Yu

Track Transitions of Care

Keywords

inter-hospital transfers

hospital medicine

advanced practice providers

qualitative study

handoff communication

patient transfer

care coordination

clinical workflow

transfer guidelines

interdisciplinary communication

Pediatric Inter-Hospital Transfer

Care Coordination

Patient Safety

Information Transfer

Communication Breakdown