The incomplete infrastructure for interhospital patient transfer

Area of Science:

• Healthcare Management
• Critical Care Medicine
• Health Services Research

Background:

• Interhospital transfer is a frequent component of care for critically ill patients.
• Existing transfer protocols often do not align with maximizing patient benefit or care value.
• Variability in hospital quality necessitates optimized transfer strategies.

Purpose of the Study:

• To review current interhospital transfer patterns for critically ill patients.
• To identify systematic barriers hindering optimal transfer integration.
• To assess transfer's role in improving patient outcomes and care value.

Main Methods:

• A narrative review of existing medical and organizational literature was conducted.

Main Results:

• Interhospital transfers are common but suboptimal, with quality not consistently driving destination choice.
• Transfer destinations are frequently determined by organizational routines or non-patient-centered priorities.
• While the physical act of transfer is safe, organizational failures in routing persist.

Conclusions:

• Technological advancements enable identification of optimal transfer facilities for critically ill patients.
• Current organizational structures fail to ensure optimal patient routing during transfers.
• Suboptimal routing may contribute to significant excess mortality among transferred patients.