Enhancing Quality in Patient Transfers: A Dashboard Approach to Track Interhospital Medical ICU Transfers

Interhospital transfers account for 1.5 million inpatient admissions annually. Yet post-transfer patient outcomes and resource utilization vary significantly. Visualizing these data can help health systems optimize transfer practices. The objective of this project was to develop a novel Interhospital Medical ICU (MICU) Transfer Dashboard displaying data on incoming medical MICU transfers to a tertiary health system and create a blueprint for other hospitals to follow.

After establishing a multidisciplinary group of physicians, nurses, administrators, data analysts, and information technology engineers, the authors used guidance from the Academic Medical Center Patient Safety Organization Inter-hospital Transfer Task Force to identify quality metrics and key variables relevant to MICU transfers. Using the Epic Clarity database and electronic health records, the authors built automated algorithms to identify transferred patients. Indicators were used to calculate relevant metrics, allowing for aggregation and visualization of desired variables.

The developed MICU Transfer Dashboard allowed visualization of key metrics, including (1) number of transfers confirmed/canceled, (2) cancellation reasons, (3) mortality within 48 hours of transfer, (4) changes in level of care within 24 hours of transfer (downgrades/upgrades to ICU, medical/surgical floors), and (5) time from request to transfer. Additional variables added during iterative refinement included patient acuity (Sequential Organ Failure Assessment [SOFA] score), length of stay after transfer, organ transplant procedure encounter, and discharge dispositions.

To the authors' knowledge, this is among the first published reports of a dashboard capturing quality metrics for interhospital MICU transfers. Early learnings from the dashboard have identified process gaps, refined workflows, and leveraged technology to optimize transfers at the health system.