Tessa Quinn
Transferring between hospitals is an important aspect of patient care, often undertaken to improve upon the existing management of the patient. Patients have the right to transfer to another hospital, and there are a variety of reasons why they may choose to do so. This could be due to dissatisfaction with the quality of care, the hospital lacking the necessary expertise, or the patient's preference to stay in a hospital closer to their loved ones. When considering a transfer, it is crucial to first determine the desired hospital and ensure they have the capacity and capability to provide the necessary care. While the process of transferring medical records can be challenging, it is important to ensure your new physician has access to your medical information for accurate diagnoses and safe treatment.
| Characteristics | Values |
|---|---|
| Reasons for transfer | The hospital can't provide the care the patient needs, the patient or their family is dissatisfied with the quality of care being delivered, the patient needs to be closer to family, etc. |
| Who initiates the transfer? | The patient or their family, with the help of a medical expert and loved ones |
| What is needed for the transfer? | An accepting doctor at the new hospital, written and informed consent of the patient's relatives, patient stability and clinical appropriateness for transfer documented by the sending physician |
| Transfer process | The sending hospital contacts nearby medical centers that offer the service needed, the accepting hospital makes a decision, the transferring and receiving facilities communicate and share information about the patient's clinical condition, treatment, reasons for transfer, mode and timeline of transfer |
| Transfer types | Primary, inter-hospital, intra-hospital |
| Transfer guidelines | Existing international guidelines from various professional bodies in developed countries, which can be modified for developing countries |
| Transfer risks | Additional risk and expense for the patient, their family and the hospital, adverse effects on patient prognosis if not executed properly |
| Transfer delays | Staffing or bed shortages, insurance form completion |
| Transfer of medical records | Request medical records be sent to a new doctor or get a personal copy, fill out an authorization form, pay any fees, make copies and store them digitally |
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What You'll Learn
- Reasons for transfer: proximity to family, dissatisfaction with care, or lack of specialty
- Patient or family initiates the transfer process
- The patient's current hospital arranges the transfer
- The patient's medical records are transferred to the new hospital
- The patient is transferred by land or air transport
Reasons for transfer: proximity to family, dissatisfaction with care, or lack of specialty
A hospital transfer refers to the movement of a patient from one care setting to another. Patients may request a transfer to another hospital for a number of reasons, including proximity to family, dissatisfaction with care, or a lack of specialty.
Being close to family is an important factor in a patient's recovery. Transfers can be requested to hospitals that are nearer to loved ones, so that patients can receive support from their family members during their stay.
Dissatisfaction with care can also prompt a transfer. This may be due to a breakdown in communication between the provider and patient, or a perception that the quality of care is not up to standard. In these cases, asking about a transfer can spur the current provider to improve their communication and address the patient's concerns.
Sometimes, a hospital may lack the necessary expertise or specialism to provide care. For example, a patient may arrive at a small hospital following a major road accident, but the hospital does not have a trauma centre. In this case, the patient would be transferred to a hospital with the appropriate facilities. Similarly, if a patient requires a specific procedure, such as interventional radiology, but the hospital does not have the required staff or equipment, they may be transferred to another facility.
It is important to consult with your insurance company when arranging a transfer, to ensure that the preferred hospital is in-network and that any ambulance transportation will be covered.
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Patient or family initiates the transfer process
Patients or their families may initiate the transfer process for a variety of reasons, such as dissatisfaction with the quality of care, the hospital lacking the necessary expertise or equipment, or simply preferring a hospital closer to their loved ones.
If a patient or their family wishes to transfer to another hospital, they must first find a physician at the new hospital who is accepting patients to ensure a safe environment that can cater to their needs. This can be challenging, as there is no central authority to facilitate the transfer. It is also important to note that the new hospital must have the capacity and capability to provide the necessary care.
Once a suitable hospital is identified, the patient's family should request a social worker or patient relations professional to act as an intermediary between all parties, especially if there has been a breakdown in communication with the current hospital. The patient or their family should also be prepared for potential delays in the transfer process due to staffing or bed shortages, as well as insurance-related issues.
To initiate the transfer, the patient or their family should contact the transfer center at the new hospital. Transfer centers are centralized departments within hospitals that coordinate patient transfers and communication between the referring and accepting hospitals. The transfer center nurse will collect initial information, such as the patient's diagnosis, and connect with the appropriate accepting provider. The nurse will then facilitate a discussion between the referring and accepting providers to reach a decision about the transfer. After a decision is made, the transfer center nurse may also assist with logistics, such as transportation, bed assignments, and insurance approval.
Throughout the transfer process, it is crucial to maintain open and effective communication between all parties involved to ensure optimal patient outcomes and continuity of care.
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The patient's current hospital arranges the transfer
When a patient needs to be transferred from one hospital to another, it is usually because the patient requires a level of care that cannot be provided at the current hospital. This could be due to a lack of specialised equipment or staff, or because the patient would benefit from a different type of facility, such as a cancer-focused centre.
The patient's current hospital will first need to find an accepting physician at the new hospital to ensure the patient's needs can be met. The decision to transfer the patient is typically made by a senior consultant-level doctor, who will discuss the benefits and risks with the patient's family. Written and informed consent from the patient's family, along with the reason for transfer, is mandatory before the transfer can take place.
The current hospital will then need to communicate directly with the receiving facility, sharing complete information on the patient's clinical condition, treatment, reasons for transfer, mode of transfer, and timeline. This complex exchange of information and collaboration between providers is facilitated by transfer centres, which are centralised departments within hospitals that coordinate the care of transferred patients and the communication between providers. Transfer centre nurses play a crucial role in collecting initial information from the referring provider, such as the patient's diagnosis, and connecting the referring provider with the accepting provider.
To ensure a safe transfer, the current hospital must also consider the appropriate mode of transfer (land or air transport), the personnel accompanying the patient, and any equipment and monitoring required during the journey.
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The patient's medical records are transferred to the new hospital
Transferring patient medical records from one hospital to another is a common occurrence, especially when the initial hospital facility lacks specialty care for the patient. However, there is no structured way to ensure that patient medical records arrive at the receiving institution. This has resulted in significant, and even life-threatening, outcomes.
To transfer patient medical records to a new hospital, the patient's current health records and test results should be made available to the new hospital to supplement physician-to-physician conversations. This can be done by first asking the new hospital about their preferred method of receiving patient medical records. Some hospitals may prefer to receive CDs rather than hard copy files, while others may have a dedicated email address for such records. The patient can then request their medical records from their current hospital and have them sent to the new hospital via the preferred method.
Alternatively, the patient can request a copy of their medical records and deliver them to the new hospital themselves. This can be done by requesting a copy of their medical records from their current hospital and either downloading them from a patient portal or receiving them through the mail. The patient can then deliver these records to the new hospital in person or by uploading them to the new hospital's patient portal.
It is important to note that there may be a significant wait time to receive or transfer medical records, and some providers may charge a fee for burning CDs or printing copies of medical records. Additionally, the patient's medical records may already be accessible to the new hospital if the hospitals use an EHR that can securely share data.
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The patient is transferred by land or air transport
When a patient is transferred between hospitals, the primary goal is to maintain the continuity of their medical care. This process is often initiated because the transferring hospital lacks the necessary resources or specialised expertise to treat the patient. For example, a patient may require a specific procedure such as dialysis or interventional radiology, which the current hospital cannot perform.
When it comes to patient transfer by land or air transport, several factors must be considered to ensure the patient's safety and well-being. Firstly, the patient's health status and ability to withstand the rigours of travel are crucial. For instance, some critically ill or injured patients may not tolerate the challenges of land travel, such as traffic, speed variations, and road hazards. In such cases, air transport may be preferable. However, air transport also has its challenges, including extreme noise levels and potential fluctuations in temperature and air pressure, which can impact patient comfort and health. Therefore, the mode of transport should be carefully selected based on the patient's condition and the distance to be travelled.
When transferring a patient by land, ground ambulances are typically used. These ambulances are equipped to handle stable patients travelling shorter distances. However, for longer journeys, fully equipped ground ambulances with intensive and continuous care capabilities may be required. Commercial medical escort services are also an option for patients who need supervision or monitoring during transport but do not require a time-critical ambulance response.
Air transport is typically utilised for long-distance patient transfers, especially in critical or time-sensitive situations. Air ambulances, helicopters, and fixed-wing aircraft are commonly used for this purpose. Air transport is particularly advantageous when transferring patients from rural hospitals to major hospitals for higher-level care or when reuniting patients with their families. It is important to note that patients must be non-combative and pose no danger to themselves or others during air travel. Additionally, the availability of landing facilities at the receiving hospital is a crucial consideration when opting for air transport.
To ensure a safe and smooth transfer process, it is essential to have open communication between the transferring and receiving facilities. This includes sharing complete information on the patient's clinical condition, treatment, reasons for transfer, mode of transfer, and timeline. Obtaining informed consent from the patient's relatives and addressing any concerns they may have is also vital. By following established guidelines and periodically assessing the quality of the transfer process, hospitals can enhance patient safety and care during these critical transitions.
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