SHM Converge Scientific Abstract ePoster Gallery-One Step Closer to Home: Assessing the Effectiveness of Iterative Process Improvement to Increase Interhospital Transfer Return Transfers

One Step Closer to Home: Assessing the Effectiveness of Iterative Process Improvement to Increase Interhospital Transfer Return Transfers

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This study examined whether two workflow changes increased “return transfers,” where patients transferred to a higher-level center are later sent back to the original hospital once specialized care is no longer needed. At Thomas Jefferson University Hospital, the team introduced a standardized transfer note prompt in January 2023 to encourage discussion and documentation of return-transfer agreements, followed by an EHR banner in February 2024 to make those agreements more visible.<br /><br />Using transfer center logs, EHR data, and Vizient discharge data, the authors analyzed Department of Medicine interhospital transfers across three periods: pre-intervention (Phase 0), after the templated note prompt (Phase 1), and after the EHR banner (Phase 2). Return transfers were confirmed by matching the outbound transfer to the original sending hospital.<br /><br />Results showed no return transfers in Phase 0 (0/247, 0%). After the note prompt was implemented, return transfers rose to 4.2% (25/601), a statistically significant increase. After the EHR banner was added, the rate increased further to 5.2% (16/305), which was a significant increase from baseline but not a statistically significant improvement over Phase 1.<br /><br />The authors conclude that adding a prompt to the acceptance note was associated with more return transfers, and the EHR banner may have provided a modest additional benefit. They note that overall return-transfer rates remain low and that more research is needed to understand whether these transfers improve resource matching, patient convenience, and continuity of support, as well as to ensure they do not introduce new safety risks.

Asset Subtitle

Alan Kubey

Meta Tag

Author List Alan Kubey, Coby Felts, David Bemis, Jeffrey Riggio, Joshua Marks, Kennedy Gallagher, Natalie Margules

Category Research

Concept Interhospital Transfer Process

Concept Transfer

Concept Transfer Rate

Concept Quality Improvement

Concept Patient Safety

Distinguished Non-Finalist

Presenter Organization Thomas Jefferson University and Mayo Clinic

Presenting Author Alan Kubey

Track Transitions of Care

Keywords

return transfers

interhospital transfers

workflow changes

EHR banner

standardized transfer note

acceptance note prompt

Department of Medicine

Thomas Jefferson University Hospital

transfer center logs

patient continuity

Interhospital Transfer Process

Transfer

Transfer Rate

Quality Improvement

Patient Safety