Interfacility Patient Transfers During COVID-19 Pandemic: Mixed-Methods Study.

Area of Science:

• Healthcare management
• Public health
• Emergency medicine

Background:

• The United States lacks a national system for coordinating interfacility patient transfers.
• The COVID-19 pandemic overwhelmed hospitals, creating significant challenges in transferring sick patients.

Purpose of the Study:

• To explore clinician experiences with newly implemented transfer coordination centers.
• To assess the impact of transfer centers on patient transfer difficulties during the COVID-19 pandemic.

Main Methods:

• A mixed-methods approach combining a national survey and in-depth qualitative interviews.
• National survey administered to the American College of Emergency Physicians Emergency Medicine Practice Research Network (EMPRN) in March 2021.
• Semi-structured interviews conducted with administrators and rural emergency clinicians in Arizona and New Mexico (September-December 2021).

Main Results:

• Only 30% of survey respondents reported the implementation or expansion of a transfer coordination center during COVID-19.
• Hospitals with new transfer centers reported no change in transfer difficulty, while those without experienced increased difficulty.
• Qualitative interviews revealed themes of pre-existing resource limitations, increased transfer distances during the pandemic, positive workflow impacts, and potential for continued center use.

Conclusions:

• Transfer centers may have mitigated pandemic-related patient transfer challenges.
• Ongoing access to transfer coordination services could particularly benefit clinicians who frequently transfer patients.