Patient transfer practices by hospitals in Western Kenya

Area of Science:

• Emergency Medicine
• Healthcare Management
• Patient Safety

Background:

• Critically ill and emergency patients frequently require inter-hospital transfers for specialized care.
• Effective patient transfer is crucial for maintaining the continuum of care and achieving favorable outcomes.
• Specialty care availability often dictates patient destination, increasing the need for safe and efficient transfers.

Purpose of the Study:

• To identify the discrepancies between established patient transfer knowledge and actual hospital practices.
• To assess the quality of patient transfers from Western Kenyan hospitals to Moi Teaching and Referral Hospital (MTRH).

Main Methods:

• A cross-sectional descriptive study was conducted.
• Data were collected from patients transferred to the Accident and Emergency department of MTRH over six months.
• 97 patient transfers were evaluated for adherence to transfer principles.

Main Results:

• Significant deficiencies were observed in ambulance use (56%), provision of escorts (60%), en route monitoring (24%), and thermal support (62%).
• Essential medical interventions during transport were frequently inadequate, including respiratory support (14-32%), resuscitation (27%), and basic procedures like intubation (30%) and catheterization (23%).
• Improper stabilization for fractures (50%) and cervical spine injuries (3%) were also noted, indicating a failure to apply critical care principles.

Conclusions:

• Hospitals in Western Kenya demonstrated significant failures in applying patient transfer principles.
• The study highlights a critical gap between recommended practices and the reality of inter-hospital patient transfers in the region.
• Urgent improvements in emergency transport protocols and training are necessary to enhance patient safety and care quality.