Study highlights inefficient transfer of stroke patients between facilities

In a new study, the transfer of a patient with stroke from a regional facility to a comprehensive center was inefficient and associated with significant delays that influenced clinical outcomes, researchers reported at the Society for NeuroInterventional Surgery Annual Meeting.

Delays in patient transfer were observed even when air transportation was used or when the two locations were close in distance, according to the researchers.

The study included data on 70 patients with acute stroke who were initially treated at six regional hospitals within 120 miles of Vanderbilt University Medical Center in Nashville, Tennessee (range, 18 to 119 miles). The researchers defined “transfer time” as the period between a call requesting a patient transfer and arrival at the center. They compared the mean transfer time for each of the referring hospitals to the drive time from the center to each facility, as indicated by Google Maps.

The mean transfer time was 97.8 minutes. In all cases, transfer time was significantly longer than the anticipated driving time; the mean difference between the two times ranged from 46 minutes to 133 minutes for each hospital.

Hospitals furthest from the comprehensive center exhibited the smallest difference between transfer time and actual drive time. The researchers noted that this was likely due to more frequent use of air transportation. In addition, several of the longest transfer times occurred when traveling from the facilities nearest to the center, according to the findings. There were no cases in which transfer time was faster than the estimated drive time, even with the use of air transportation.

The researchers called for improved efficiency in acute stroke care, citing the importance of rapid revascularization. They suggested a focus on early diagnosis, and potentially bypassing local hospitals altogether in some stroke cases in order to bring patients directly to comprehensive facilities.

“It’s important that we continue to inform best practices and evolve our systems for the good of patients who depend on rapid response and timely intervention,” Michael Froehler, MD, neurointerventionist at Vanderbilt University Medical Center, said in a release. “We must rigorously apply the same evidence-based standards that we use for individual patient treatment decisions to the broader systems of care in order to achieve necessary efficiencies that can make a real difference for our patients.” – by Adam Taliercio

For more information:

Froehler M., et al. Presented at: Society of NeuroInterventional Surgery Annual Meeting; July 27-30, 2015; San Francisco.

Disclosure: The researchers report no relevant financial disclosures.