Speaker: Numerous improvements needed in patient-transfer process

BOSTON — The error rate for the neurosurgical patient-transfer process is high, and the process can be improved on numerous fronts, according to a speaker here.

Christopher M. Holland, MD, and colleagues analyzed all transfer requests to the Emory Neurosurgical Service for 1 year. Their study attempted to complete in-depth chart reviews for all transfer cases, evaluate declined/failed-to-arrive transfers, and identify trends and opportunities for improvement.

Holland presented the results of the study at the Congress of Neurological Surgeons Annual Meeting.

A total of 984 patients arrived at one of the institutions included in the study. Patients arrived from 133 unique referring facilities, with the most common diagnosis being intracranial hemorrhage, reported in 31.8% of patients. Spinal diagnosis was reported for 6.3%, according to Holland.

Median travel time for transfer patients was 36 minutes, but the median interval between the initial request and patient arrival was 4 hours and 2 minutes.

Overall diagnostic error rate was at 10.3%, and 57 patients were inappropriately admitted to intensive care and later transitioned to a lower level of care, according to Holland.

“Areas for improvement include improving diagnostic accuracy at our outside facilities via tele-radiology, which can help us determine more appropriate transportation methods, appropriate levels of care, and expedite interventions and patient care,” he said.

Improving efficiency of transfer in anticipation of patient arrival and optimizing resource utilization and cost effectiveness are also key, according to Holland.

Reference:

Holland CW. Paper #134. Presented at: Congress of Neurological Surgeons Annual Meeting; Oct. 18-22, 2014; Boston.

Disclosure: Holland has no relevant financial disclosures.