Barriers to Communication and Information Exchange in Patient Transfer and Its Consequences

Abstract

Background & Objectives:The patient transfer is multidisciplinary process and communication and information exchange are crucial for its successful accomplishment. The purpose of this study was to identify barriers that negatively influence communication and information exchange during the patient transfer between hospitals and the Center for Treatment Guidance and Information (CTGI) and to describe their consequences. Methods:A qualitative study based on Focus Group Discussion (FGD) and semi-structured interviews were conducted. Three FGDs were carried out with 5 experts with years of experience working in the CTGI and 25 interviews with individuals involved in patient transfer process. Data were analyzed using content analysis method.Findings: Three major themes including poor communication and information exchange at the CTGI, referring hospital, and receiving hospital were identified. The most important sub-themes at the level of CTGI were: the unavailability of accurate patient medical history and lack of confidence and different working process for patient admission in hospitals. At the level of referring hospital they were incomplete medical history, medical documents, vague patient transfer indications and lack of effective communication. At the level of receiving hospital they were lack of providing feedback, lack of mutual communication and incorrect report of available beds. Also four major consequences of poor communication and information exchange were identified which are managerial, clinical, economic and social consequences. Conclusions:To overcome the barriers, there is a need for proper monitoring by accountable organizations, reviewing the protocols for patient transfer, an increase in inter-sector collaboration and improvement in communications infrastructure and collection of data.

Developing and Validating a Pediatric Potentially Avoidable Transfer Quality Metric

“…Rather, based on physician medical record review, pediatric PAT represents about 15% to 21% of transferred children who had short stays at the receiving hospital. Nonetheless, given the risks (eg, safety risks, delays in care, burdens on families) 8-11,13 and high cost of transfers, 12 the relatively common occurrence of PAT found by physician medical record review in the present study supports the importance of targeting efforts to address this problem.…”

“…7 Such transfers, whether for adult or pediatric patients, are known to be fraught with communication breakdowns, diagnosis discordance, and delays in care. 8-11 Transfers can be arduous for providers, burdensome on families, risky for patients, and an inefficient use of resources. 8,12,13 Some transfers are unnecessary.…”