Ashely Sutton, MD, Associate Professor of Pediatrics in the Division of Pediatric Hospital Medicine, with a team of from across the UNC Children’s Hospital has recently published Systematic Improvement in the Patient Transfer Process to a Tertiary Care Children’s Hospital in Hospital Pediatrics. This study shares the efforts to improve the operational efficiency of communicating with outside physicians or APPs who need to transfer patients to UNC Children’s.
High quality care of hospitalized patients includes a combination of great medical care teams but also effective operational processes. Accepting and transferring patients from other hospitals can be very complex, time consuming, and a time of health risk for patients. The ability to take calls from outside hospitals that need help with patient management and transfer to higher levels of care is an important part of the role UNC Children’s plays in the system of healthcare in North Carolina. Having effective transfer processes improves care for patients but also improves relationships with outside referring clinicians. As most hospitals in the state do not provide inpatient care to children and few are well equipped to deal with pediatric emergencies, the transfer process is especially important for UNC Children’s.
UNC Children’s implemented a wide variety of interventions to improve the efficiency of the transfer process for outside referring providers and patients. Interventions that seemed to have the greatest effect include creating a physician role specifically focused on transfers, creating a direct line to that person, and changing the culture to one where the referring provider received an immediately transfer acceptance for the patient to UNC Children’s while the specific team or unit to care for the patient was determined subsequently. These changes in addition to other adjustments cut the time to respond to referring providers in half and greatly decreased the number of physicians involved in the transfer process. UNC Children’s has experienced a dramatic increase in the volume of referred patients over the years while improving this process.
Since initiating these changes, other care teams at UNC have also implemented similar consolidated transfer roles including Medicine and the Emergency Department. Other services are also considering similar changes.