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Inter-hospital Transfer Decision-making During the COVID-19 Pandemic: a Qualitative Study
Emily A Harlan1,2,3, Eman Mubarak4, Janice Firn5,6,4
1Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Michigan, Ann Arbor, MI, USA. schwessi@med.umich.edu.
Journal of General Internal Medicine
|May 30, 2023
Summary
Healthcare workers face moral distress due to scarce resources and lack of guidance during inter-hospital patient transfers. Improving transfer processes can alleviate this distress and ensure equitable patient care.
Area of Science:
- Healthcare Management
- Medical Ethics
- Public Health
Background:
- Inter-hospital patient transfers can improve outcomes by connecting patients with specialized resources.
- Limited guidance exists for prioritizing patient transfers during resource scarcity, particularly during pandemic surges.
Purpose of the Study:
- To explore healthcare workers' experiences with inter-hospital patient transfers during a pandemic surge.
- To identify factors influencing decision-making for accepting inter-hospital patient transfers.
Main Methods:
- Qualitative study using semi-structured interviews with physicians, nurses, and administrators involved in transfer acceptance.
- Interviews conducted with 21 participants from 15 hospitals in Michigan between October 2021 and February 2022.
Main Results:
- Three key themes emerged: decision-maker, patient, and environmental factors influenced transfer decisions.
- Decision-makers reported a lack of clear guidance, impacting patient selection and causing moral distress.
- Scarce resources, organizational changes, and virtual care alternatives were significant environmental factors.
Conclusions:
- A lack of standardized guidance for inter-hospital transfers leads to variability and moral distress among healthcare professionals.
- Findings suggest organizational changes to improve transfer processes and mitigate moral distress.
Keywords:
COVID-19 pandemichospital straininter-hospital transferphysician decision-makingscarce resource allocationMore Related Videos
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