SHM Converge Scientific Abstract ePoster Gallery-Identifying Barriers to Interhospital Transfer From an Academic Medical Center to an Affiliated Community Hospital

Pdf Summary

This retrospective study examined barriers to transferring patients from a large academic medical center (AMC) to an affiliated community hospital (CH) over one year. The goal was to identify why eligible lower-acuity patients could not be moved, with the broader aim of expanding inpatient capacity across the health system.<br /><br />Triage hospitalist notes from 6,217 admissions were reviewed. Using a structured documentation template, hospitalists recorded factors affecting transfer decisions, including specialty service needs, patient assent, bed availability, staffing restrictions, and acuity. The team then used SQL queries to calculate how often each barrier occurred.<br /><br />The most common barrier was specialty service requirement, which appeared in 3,349 cases (53.9% of all documented barriers). The most frequently needed services included oncology, neurology, neurosurgery, hepatobiliary care, interventional radiology, and other internal medicine subspecialties. When patients had no other major barrier, 60% declined transfer when offered, and 55% could not transfer because of staffing-related concerns.<br /><br />Overall, the study found that subspecialty availability, patient willingness to transfer, and appropriate level-of-care availability were the main obstacles to interhospital transfer. These findings have already informed institutional efforts to increase transfer capacity, including expanding consultant coverage at the community hospital and improving patient consent processes and bed access.

Asset Subtitle

Neal A. Tambe

Meta Tag

Author List Anne Ritchie, Bradley Monash, Lauren Linett, Lukejohn W. Day MD, MBA, Maggie Jones, Michelle S. Mourad, Neal A. Tambe, Salman Rahman, Yumiko Abe-Jones

Category Research

Concept Interhospital Transfer Process

Concept Transfer Barrier

Concept Specialty Service

Concept Assent

Concept Staffing

Distinguished Non-Finalist

Presenter Organization UCSF Division of Hospital Medicine

Presenting Author Neal A. Tambe

Track Transitions of Care

Keywords

interhospital transfer

academic medical center

community hospital

barriers to transfer

specialty service requirement

patient assent

bed availability

staffing restrictions

subspecialty availability

inpatient capacity

Interhospital Transfer Process

Transfer Barrier

Specialty Service

Assent

Staffing