Transfer of patients--from the spoke to the hub

We describe the nature, frequency, and characteristics of transfers to a regional centre. This was a three month prospective descriptive study of all transfers into the hospital through the ED and a further sample survey of 100 patients received into the resuscitation room over a 2 year period. 105 patient transfers were surveyed over the three month period. A significant number (43 patients) arrived at the ED without prior notification being received by ED staff, a proportion (7 patients) warranting resuscitation room assessment. The rate of Doctor Transfer was 22%. Of the 23 patients that warranted assessment in the resuscitation room 10 were unaccompanied by a Doctor and 5 were unaccompanied by either a Doctor or a Nurse. 11% of transfers had no transfer letter or radiographs. Only 51% of transferred patients had an IV line in situ. 4 out of the 8 transfers into the resuscitation room performed by interns were associated with adverse events. There continues to be problems with the quality of care that these patients receive. Clinicians must be actively involved in the development of regional transfer protocols and interfacility agreements to ensure the safe transfer of patients to definitive care.