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Emergency Pediatric Orthopaedic Transfer Criteria: A Pilot Study
Gregory S Mowrer1, Nicholas I Pilla1, Scott M Sorenson2
1Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania.
Journal of Surgical Orthopaedic Advances
|January 22, 2024
Summary
Many pediatric orthopaedic transfers to Level I trauma centers do not meet established criteria. Implementing clear transfer guidelines can reduce potentially avoidable inter-facility patient transfers.
Area of Science:
- Pediatric Orthopaedics
- Trauma Surgery
- Healthcare Management
Background:
- Inter-facility transfers are common in pediatric orthopaedics.
- Establishing clear transfer criteria is essential for efficient patient care and resource allocation.
Purpose of the Study:
- To define pediatric orthopaedic transfer criteria for patients referred to a Level I pediatric trauma center.
- To evaluate the appropriateness of current transfer requests.
Main Methods:
- A 10-question phone survey was used to collect data on transfer requests.
- Fifty-eight transfer requests were prospectively collected and retrospectively reviewed.
- Criteria were based on The American Academy of Pediatrics (AAP) guidelines and expert opinion.
Main Results:
- 64% of pediatric orthopaedic transfers did not meet the defined criteria.
- Transfer requests originated from various healthcare providers, including Emergency Department physicians and physician assistants.
- Referring orthopaedic surgeons examined patients prior to transfer in only 10% of cases.
Conclusions:
- A significant proportion of pediatric orthopaedic transfers to a Level I trauma center were potentially avoidable.
- Development and implementation of standardized transfer criteria are recommended to optimize patient management and resource utilization.
