SHM Converge Scientific Abstract ePoster Gallery-The Impact of Cognitive Load and Trust in Inter-Hospital Transfers

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This study examined cognitive load and trust in inter-hospital transfers (IHTs) at an academic medical center. Using 1-hour semi-structured interviews with 30 inpatient hospital medicine physicians and advanced practice providers, the researchers used thematic analysis to identify sources of cognitive overload and potential solutions.<br /><br />Participants reported that IHT care creates high cognitive load because of frequent task switching, such as taking transfer acceptance calls while managing other clinical duties. They also described problems with how information is presented: transfer details were often extraneous, missing, redundant, or poorly organized, making it hard to quickly understand the patient’s condition and needs. These challenges made sense-making and synthesis of relevant clinical information difficult.<br /><br />Trust emerged as an important factor that was not fully captured in the study’s initial framework. Clinicians said that trust supports smoother workflows and more efficient processing of transfer information, while distrust acts as a barrier. Transfers from the emergency department were often viewed more favorably because clinicians trusted the referring colleagues and their assessment of acuity.<br /><br />The authors conclude that inefficiencies in information and task organization contribute to clinician stress and may increase the risk of errors during IHTs. They recommend two main strategies: assigning dedicated IHT personnel to handle acceptance calls and admissions, and standardizing how IHT information is collected and presented to improve consistency and quality. Addressing these issues may reduce cognitive overload, strengthen trust, and improve the safety and experience of inter-hospital transfer care.

Asset Subtitle

Amy Yu

Meta Tag

Author List Amy Yu, Anna Maw, Brooke Dorsey Holliman, Christine Jones, Claire Westcott, Jacinda Nicklas, Lauren McBeth, Mustafa Ozkaynak, Stephanie K. Mueller

Category Research

Concept Cognitive Load

Concept Pediatric Inter-Hospital Transfer

Concept Task Switching

Concept Information Presentation

Concept Medical Error

Distinguished Non-Finalist

Presenter Organization University of Colorado

Presenting Author Amy Yu

Track Transitions of Care

Keywords

inter-hospital transfers

cognitive load

trust

task switching

information presentation

clinical workflow

transfer acceptance calls

thematic analysis

physician interviews

patient safety

Cognitive Load

Pediatric Inter-Hospital Transfer

Task Switching

Information Presentation

Medical Error