SHM Converge Scientific Abstract ePoster Gallery-Unnecessary Inter-Hospital Transfers: Exploring Incidence, Reason, Impact, and Improvement Opportunities

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This exploratory chart review examined potentially inappropriate inter-hospital transfers (IHTs) to Medicine services at a single hospital over about one month in 2023. IHTs are common but inconsistently standardized, which can lead to variation in transfer decisions, safety, outcomes, and cost. The study, part of the POINT project, aimed to estimate how often transfers were inappropriate, assess any safety impact, and examine whether a site-specific templated transfer note was associated with better documentation or fewer inappropriate transfers.<br /><br />A total of 61 transfer events were reviewed; 42 met inclusion criteria for double adjudication. Two independent reviewers classified transfers using a standardized scale from highly inappropriate to highly appropriate. Three transfers were judged inappropriate, yielding an estimated inappropriate IHT rate of 7.1%. All inappropriate transfers were driven at least in part by patient or family preference. Importantly, none involved a condition that required a level of care unavailable at the sending hospital, and there were no transfer-related adverse events or escalations in care within 24 hours.<br /><br />Transfer communication was documented in 26 charts. Among these, 16 used a Jefferson-developed templated electronic note and 10 used non-templated notes. In this small sample, no-note cases had 0% inappropriate transfers, non-templated notes had a 66.7% inappropriate rate, and templated notes had a 33.3% rate, though numbers were very small.<br /><br />Overall, the analysis suggests that truly inappropriate IHTs were uncommon and did not appear to cause immediate safety issues. The authors plan to expand the study to better understand transfer appropriateness and to guide efforts to reduce unnecessary physical transfers and improve care delivery.

Asset Subtitle

Kennedy Gallagher

Meta Tag

Author List Alan A. Kubey, Joshua Marks, Kennedy Gallagher

Category Research

Concept Patient Transfer

Concept Potentially Inappropriate Transfer

Concept Chart Review

Concept Transfer-related Adverse Event

Concept Transfer Practice

Distinguished Non-Finalist

Presenter Organization Sidney Kimmel Medical College at Thomas Jefferson University

Presenting Author Kennedy Gallagher

Track Transitions of Care

Keywords

inter-hospital transfers

inappropriate transfers

medicine services

chart review

transfer appropriateness

patient preference

transfer documentation

templated note

patient safety

POINT project

Patient Transfer

Potentially Inappropriate Transfer

Chart Review

Transfer-related Adverse Event

Transfer Practice