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Calling the Burn Center: Optimizing Referrals and Resource Utilization
Moon Usman1, Omar Shehoud1, Juan Jose Lizardi1
1Yale New Haven Health/The Connecticut Burn Center 267 Grant St, Bridgeport, CT 06610, United States.
Abstract:
Burn centers are vital for managing burn injuries, with timely referral being crucial for optimal care. The American Burn Association (ABA) provides referral criteria to help healthcare providers identify patients needing specialized treatment. However, adherence to these guidelines varies, leading to inefficiencies in resource use. This study assesses consultation patterns and hospital size on referral practices and outcomes at a state burn center. A retrospective review of 588 telephone inquiries between January 1 and December 31, 2024, was conducted. Data on hospital size, adherence to ABA guidelines, and patient disposition (admission, referral to ED, or outpatient follow-up) were analyzed using chi-square tests (P < .05). Of the 588 inquiries, 29% came from larger hospitals (≥300 beds), with 34% resulting in-patient admissions. In contrast, 36% of calls were from smaller hospitals (<100 beds), with only 20% leading to admissions. Larger hospitals adhered to ABA guidelines more often (72%) compared to smaller hospitals (25%), with a P-value of .02. Larger hospitals were 1.21 times more likely to have referrals admitted than medium-sized hospitals and 1.7 times more likely than smaller hospitals (P < .005). Overall, 35% of referrals led to admissions. Hospital size significantly influences adherence of guidelines and referral outcomes. Larger hospitals are more likely to follow guidelines and admit patients. Combining structured telehealth programs with enhanced educational initiatives and outreach for referring hospitals may improve efficiency, optimize resource use, and strengthen burn care delivery.
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