Interhospital transfers of patients with surgical emergencies: Areas for improvement

Wong, Kenneth C.; Lévy, Richard

doi:10.1111/j.1440-1584.2005.00719.x

Cited by 20 publications

(39 citation statements)

References 10 publications

(10 reference statements)

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“…If implemented by other trusts, this model will effectively improve the quality of care and the outcome of surgery, and reduce stress for patients, relatives and physicians in the referring hospitals [4].…”

Section: Resultsmentioning

confidence: 99%

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Surgical management of pneumothorax: significance of effective admission or communication strategies between the district general hospitals and specialized unit

Aslam

Martin-Ucar

Nakas

et al. 2011

Interactive CardioVascular and Thoracic Surgery

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A preoperative delay in emergency surgery for spontaneous pneumothorax is associated with a poor outcome after surgery and a prolonged hospital stay. To reduce preoperative delays, all tertiary referrals from district general hospitals to our thoracic surgery unit were processed through a 'clinical decisions unit' (CDU). Prior to the establishment of the CDU, these patients were added to a waiting list for a surgical bed. This study has reviewed the effect of this change in admission policy on the efficiency of treatment for non-elective spontaneous pneumothorax. An intergroup comparison (pre-CDU group vs. post-CDU group) was made of the following parameters: referral to transfer time, transfer to surgery time and length of inpatient stay in the referring and tertiary hospitals. There were no significant differences in gender, diagnosis, treatment in the referring hospitals, postoperative clinical outcome, or indications for or type of surgery. The total length of inpatient stay in the referring and tertiary hospitals was significantly reduced for the post-CDU group (12 vs. 15 days; P<0.001), which was attributed to the earlier transfer of patients (18 vs. 78 hours; P<0.001) hours. Allowing surgical access to a traditional medical admission unit is therefore, cost-effective and significantly improves the efficiency of non-elective pneumothorax surgery.

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Section: Resultsmentioning

confidence: 99%

“…Prolonged waiting for transfer to a tertiary centre causes considerable anxiety to patients and accounts for suboptimal care [4]. Waiting is not only a cause of avoidable occupancy of National Health Service (NHS) beds, but is also associated with longer waits in Accident and Emergency units [5].…”

Section: Introductionmentioning

confidence: 99%

Surgical management of pneumothorax: significance of effective admission or communication strategies between the district general hospitals and specialized unit

Aslam

Martin-Ucar

Nakas

et al. 2011

Interactive CardioVascular and Thoracic Surgery

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show abstract

“…Unfortunately, inter-hospital transfer of critically ill patients can result in intensive care management being delayed until arrival at the receiving hospital [27], particularly if a formalized and adequately funded retrieval service is not available or the retrieval service is not staffed by appropriately trained medical personnel [28,29]. Prompt, rapid and efficient transfer requires early recognition of the need for retrieval, a streamlined communication process, and the 24-h availability of multiple modes of transport (i.e.…”

Section: Retrieval Of Patients From Rural To Metropolitan Intensive Cmentioning

confidence: 98%

Supporting rural community-based critical care

Peake

Judd

2007

Current Opinion in Critical Care

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A number of solutions for supporting critical care in rural communities exist. None of these strategies are stand-alone solutions, nor are they universally applicable. Individual healthcare regions need to implement different strategies depending on local requirements and resources. Ultimately, lobbying for productive changes to healthcare policy will ensure the long-term viability of rural critical care.

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“…37 Evidence is also lacking about the factors that determine which patient is suitable for transfer. However, in one survey of intensive care physicians, the availability of suitable personnel and facilities was thought to be more important than patientlevel factors.…”

Section: Transfer Co-ordinationmentioning

confidence: 99%

Critical Care Transfer Quality 2000–2009: Systematic Review to Inform the ICS Guidelines for Transport of the Critically Ill Adult (3rd ed)

Barratt

2012

Journal of the Intensive Care Society

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This paper describes the findings of a systematic literature review that was undertaken to inform the third edition of the Intensive Care Society's (ICS) Guidelines for the Transport of the Critically Ill Adult, which has recently been published. Thirty-eight articles were identified relating to the process of adult patient transfer. The bulk of the articles related to transfer quality, including review articles and audits assessing both the standard of transfers and compliance with relevant guidelines. The review demonstrates that the quality of transfers remains a concern, but much of the data is from single centre audits and case series, which are thought to provide the weakest level of evidence. The guidelines have been extensively updated to reflect both current practice and emerging evidence, but it is clear that measures are still needed to improve the quality of transfers.

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Interhospital transfers of patients with surgical emergencies: Areas for improvement

Cited by 20 publications

References 10 publications

Surgical management of pneumothorax: significance of effective admission or communication strategies between the district general hospitals and specialized unit

Surgical management of pneumothorax: significance of effective admission or communication strategies between the district general hospitals and specialized unit

Supporting rural community-based critical care

Critical Care Transfer Quality 2000–2009: Systematic Review to Inform the ICS Guidelines for Transport of the Critically Ill Adult (3rd ed)

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