The Development and Implementation of a Transfer Follow-up Program at a Level I Pediatric Trauma Center

Abstract

Background: Inconsistent trauma patient referral feedback limits trauma system growth and may perpetuate suboptimal care. Trauma and burn patients are transferred to our Level I pediatric trauma center from hospitals in the surrounding metropolitan area. In the past, we had no consistent method to address performance improvement opportunities or provide information on patient outcomes to the referring facilities. The purpose of this study is to describe the implementation and evaluation of a formal electronic transfer follow-up program. Methods: This was a before-and-after quality improvement study of pediatric trauma patients comparing prefeedback program implementation (2018) to postfeedback program implementation (2019). A new transfer patient feedback program was designed to address low rates of feedback provided to referring hospitals. Our center worked with a software developer to create a program that stored outside hospital contacts, automated follow-up letters, and tracked the number of letters sent, and opened, to enhance communication between trauma center and referring facilities. Results: A total of 383 preprogram (2018) patients and 369 postprogram (2019) patients were evaluated. Since program implementation, an average of 70% follow-up per referral and an average return rate of 45% have been maintained. Conclusion: As we continue to use the system and make changes, we fully expect to exceed our goal in providing essential feedback on the care of pediatric trauma and burn patients to our referring facilities.

Multiregion Trauma Center Follow-Up Protocol for Transferred Trauma Patients

“…When a patient transfer occurs within a single hospital system, patient data are available for review between transferring and receiving facilities. But when patients are transferred outside of the hospital system, access to secondary encounter information may not always be available, compromising performance improvement (Bradley et al, 2017; Colson et al, 2020; Coniglio et al, 2018; Pidgeon, 2015). To address this, the ACS requires Level I trauma centers to send feedback to referring institutions (Rae & Bulger, 2015).…”

“…One approach that can promote process improvement for transferred trauma patients is a standardized follow-up feedback process (Byrnes et al, 2010). Software-based solutions to feedback limitations that included automated letters had early success (Colson et al, 2020). To our knowledge, there is no published literature on the regional implementation of standardized reports between facilities.…”