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Interfacility transfer

Thomas V Kodankandath, Paul Wright, Paul M Power, Marcella De Geronimo, Richard B Libman, Thomas Kwiatkowski, Jeffrey M Katz
BACKGROUND AND OBJECTIVE: The transfer of acute ischemic stroke (AIS) patients to a comprehensive stroke center (CSC) must be rapid. Delays pose an obstacle to time-sensitive stroke treatments and, therefore, increase the likelihood of exclusion from endovascular stroke therapy. This study aims to evaluate the impact of the Stroke Rescue Program, with its goal of minimizing interfacility transfer delays and increasing the number of transport times completed within 60 minutes. METHODS: The Stroke Rescue Program was initiated to facilitate the rapid transfer of AIS patients from regional primary stroke centers (PSCs) to the network's CSC...
October 12, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Joyce Li, Stephanie Pryor, Ben Choi, Chris A Rees, Mamata V Senthil, Nicholas Tsarouhas, Sage R Myers, Michael C Monuteaux, Richard G Bachur
OBJECTIVES: The aim of this study was to determine the reasons for pediatric emergency department (ED) transfers and the professional characteristics of transferring providers. METHODS: We performed a multicenter, cross-sectional survey of ED medical providers transferring patients younger than 18 years to 1 of 4 tertiary care children's hospitals. Referring providers completed surveys detailing the primary reasons for transfer and their medical training. RESULTS: The survey data were collected for 25 months, during which 641 medical providers completed 890 surveys, with an overall response rate of 25%...
September 23, 2016: Pediatric Emergency Care
James H Hertzog, Thomas E Pearson, Marc A Priest, Ellen Spurrier, Ryan R Davies
Ventricular assist devices (VADs) for the mechanical support of cardiac failure are being used more frequently in children of increasingly younger age. These children have significant and multiple medical comorbidities, and their length of hospital stay has been increasing. As this population of hospitalized VAD-supported children increases, so does the possibility of their need for interfacility transport for specialized diagnostic or therapeutic procedures. Reports on such transports are limited to 3 children who underwent scheduled elective transfers...
September 2016: Air Medical Journal
Joseph Schili, Peter V R Tilney, Jacob T Gutsche, Jason Cohen
No abstract text is available yet for this article.
September 2016: Air Medical Journal
Kevin T Lynch, Rachael M Essig, Dustin M Long, Alison Wilson, Jorge Con
BACKGROUND: Secondary overtriage (SO) refers to the interfacility transfer of trauma patients who are rapidly discharged home without surgical intervention by the receiving institution. SO imposes a financial hardship on patients and strains trauma center resources. Most studies on SO have been conducted from the perspective of the receiving hospital, which is usually a level 1 trauma center. Having previously studied SO from the referring rural hospital's perspective, we sought to identify variables contributing to SO at the national level...
August 2016: Journal of Surgical Research
David Gomez, Barbara Haas, Kristian Larsen, Aziz S Alali, Russell D MacDonald, Jeffrey M Singh, Homer Tien, Theodore J Iwashyna, Gordon Rubenfeld, Avery B Nathens
BACKGROUND: More than half of severely injured patients are initially transported from the scene of injury to nontrauma centers (NTCs), with many requiring subsequent transfer to trauma center (TC) care. Definitive care in the setting of severe injury is time sensitive. However, transferring severely injured patients from an NTC is a complex process often fraught with delays. Selection of the receiving TC and the mode of interfacility transport both strongly influence total transfer time and are highly amenable to quality improvement initiatives...
October 2016: Journal of Trauma and Acute Care Surgery
Malik M Adil, Gabriel A Vidal, Lauren A Beslow
INTRODUCTION: Children with ischemic stroke (IS) and hemorrhagic stroke (HS) may require interfacility transfer for higher level of care. We compared the characteristics and clinical outcomes of transferred and nontransferred children with IS and HS. METHODS: Children aged 1-18 years admitted to hospitals in the United States from 2008 to 2011 with a primary discharge diagnosis of IS and HS were identified from the National Inpatient Sample database by ICD-9 codes...
July 21, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Matthew C Strehlow, Jennifer A Newberry, Corey B Bills, Hyeyoun Elise Min, Ann E Evensen, Lawrence Leeman, Elizabeth A Pirrotta, G V Ramana Rao, S V Mahadevan
OBJECTIVES: Characterise the demographics, management and outcomes of obstetric patients transported by emergency medical services (EMS). DESIGN: Prospective observational study. SETTING: Five Indian states using a centralised EMS agency that transported 3.1 million pregnant women in 2014. PARTICIPANTS: This study enrolled a convenience sample of 1684 women in third trimester of pregnancy calling with a 'pregnancy-related' problem for free-of-charge ambulance transport...
2016: BMJ Open
Brian J Yun, M G Myriam Hunink, Anand M Prabhakar, Marilyn Heng, Shan W Liu, Rameez Qudsi, Ali S Raja
STUDY OBJECTIVE: Hip fractures cause significant morbidity and mortality. Determining the optimal diagnostic strategy for the subset of patients with potential occult hip fracture remains challenging. We determined the most cost-effective strategy for the diagnosis of occult hip fractures from the choices of performing only computed topography (CT), performing only magnetic resonance imaging (MRI), performing CT and if negative performing MRI (MRI selective strategy), or discharging the patient without advanced imaging...
June 10, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Michael J Ward, Sunil Kripalani, Yuwei Zhu, Alan B Storrow, Thomas J Wang, Theodore Speroff, Daniel Munoz, Robert S Dittus, Frank E Harrell, Wesley H Self
Lack of health insurance is associated with interfacility transfer from emergency departments for several nonemergent conditions, but its association with transfers for ST-elevation myocardial infarction (STEMI), which requires timely definitive care for optimal outcomes, is unknown. Our objective was to determine whether insurance status is a predictor of interfacility transfer for emergency department visits with STEMI. We analyzed data from the 2006 to 2011 Nationwide Emergency Department Sample examining all emergency department visits for patients age 18 years and older with a diagnosis of STEMI and a disposition of interfacility transfer or hospitalization at the same institution...
August 1, 2016: American Journal of Cardiology
Reda A Awali, Deepthi Kandipalli, Amina Pervaiz, Sandhya Narukonda, Urooj Qazi, Naveen Trehan, Teena Chopra
BACKGROUND: Preventing the transmission of Clostridium difficile infection (CDI) over the continuum of care presents an important challenge for infection control. METHODS: A prospective case-control study was conducted on patients admitted with CDI to a tertiary care hospital in Detroit between August 2012 and September 2013. Patients were then followed for 1 year by telephone interviews and the hospital administrative database. Cases, patients with interfacility transfers (IFTs), were patients admitted to our facility from another health care facility and discharged to long-term care (LTC) facilities...
September 1, 2016: American Journal of Infection Control
Jennifer L Rosenthal, Joan F Hilton, Ronald J Teufel, Patrick S Romano, Sunitha V Kaiser, Megumi J Okumura
BACKGROUND AND OBJECTIVE: The hospital-to-hospital transfer of pediatric patients is a common practice that is poorly understood. To better understand this practice, we examined a national database to profile pediatric interfacility transfers. METHODS: We used the 2012 Kids' Inpatient Database to examine characteristics of hospitalized pediatric patients (<21 years; excluding pregnancy diagnoses) with a transfer admission source. We performed descriptive statistics to compare patient characteristics, utilization, and hospital characteristics between those admitted by transfer versus routine admission...
June 2016: Hospital Pediatrics
(no author information available yet)
No abstract text is available yet for this article.
May 2016: Annals of Emergency Medicine
Denisse Sequeira, Christian Martin-Gill, Matthew R Kesinger, Laura R Thompson, Tudor G Jovin, Lori M Massaro, Francis X Guyette
OBJECTIVE: Stroke is the leading cause of disability in the United States with most of these patients being transported by emergency medical services. These providers are the first medical point of contact and must be able to rapidly and accurately identify stroke and transport these patients to the appropriate facilities for treatment. There are many conditions that have similar presentations to stroke and can be mistakenly identified as potential strokes, thereby affecting the initial prehospital triage...
April 15, 2016: Prehospital Emergency Care
Brendan N Dragann, Eric M Melnychuk, Christopher J Wilson, Richard L Lambert, Frank A Maffei
The prognosis of pediatric patients who require prolonged resuscitation after ice water drowning and hypothermic cardiac arrest remains guarded. We report a case of successful prolonged resuscitation of a pediatric patient in hypothermic cardiac arrest who showed severe metabolic derangements and went on to make a rapid and full neurologic recovery without the use of extracoproreal rewarming or mechanical cardiac support. Many ground and air medical emergency medical service programs have policies against interfacility transfer of patients in hypothermic cardiac arrest, calling into question the need to revise current protocols...
March 2016: Air Medical Journal
Nicholas M Mohr, Karisa K Harland, Dan M Shane, Sarah L Miller, James C Torner
OBJECTIVES: Interhospital transfer is a common strategy to provide high-quality regionalized care in rural emergency departments (EDs), but several reports have highlighted problems with selection of children for transfer. The purpose of this study is to characterize the burden of potentially avoidable transfer (PAT) and to estimate the medical and family-oriented costs associated with PAT. METHODS: This study was a cohort study of all children treated in Iowa EDs between 2004 and 2013...
August 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Ralph Weber, Gernot Reimann, Christian Weimar, Angela Winkler, Klaus Berger, Hannes Nordmeyer, Jeffrie Hadisurya, Friedhelm Brassel, Martin Kitzrow, Christos Krogias, Werner Weber, Elmar W Busch, Jens Eyding
BACKGROUND: After thrombectomy has shown to be effective in acute stroke patients with large vessel occlusion, the potential benefit of secondary referral for such an intervention needs to be validated. AIMS: We aimed to compare consecutive stoke patients directly admitted and treated with thrombectomy at a neurointerventional centre with patients secondarily referred for such a procedure from hospitals with a stroke unit. METHODS: Periprocedure times and mortality in 300 patients primarily treated in eight neurointerventional centres were compared with 343 patients referred from nine other hospitals in a prospective multicentre study of a German neurovascular network...
March 2016: Therapeutic Advances in Neurological Disorders
Mark Faul, Likang Xu, Scott M Sasser
OBJECTIVE: Guidelines suggest that Traumatic Brain Injury (TBI) related hospitalizations are best treated at Level I or II trauma centers because of continuous neurosurgical care in these settings. This population-based study examines TBI hospitalization treatment paths by age groups. METHODS: Trauma center utilization and transfers by age groups were captured by examining the total number of TBI hospitalizations from National Inpatient Sample (NIS) and the number of TBI hospitalizations and transfers in the Trauma Data Bank National Sample Population (NTDB-NSP)...
September 2016: Prehospital Emergency Care
Christopher B Fordyce, John A Cairns, Joel Singer, Terry Lee, Julie E Park, Richard A Vandegriend, Michele Perry, Wendy Largy, Min Gao, Krishnan Ramanathan, Graham C Wong
BACKGROUND: We describe the evolution of a regional system designed to provide primary percutaneous coronary intervention (pPCI) as the preferred method of revascularization for ST-elevation myocardial infarction (STEMI) and its impact on first medical contact (FMC)-to-device times and in-hospital outcomes. METHODS: Patients with STEMI presenting to the Vancouver Coastal Health Authority between June 2007 and January 2015 (N = 2503) were categorized according to 3 sequential phases: phase 1 = standardization of reperfusion algorithms; phase 2 = use of prehospital electrocardiograms; phase 3 = expedited interfacility transfer for pPCI...
December 19, 2015: Canadian Journal of Cardiology
Alex L Gornitzky, Andrew H Milby, Melissa A Gunderson, Benjamin Chang, Robert B Carrigan
Several studies have identified the inappropriate use of emergent interfacility transfer as an opportunity to improve health care use. The authors sought to identify common characteristics among children who were transferred from a community hospital to a pediatric tertiary care center for definitive treatment of hand/wrist injuries. All patients undergoing emergent transfer to a pediatric Level I trauma center and academic tertiary referral center for evaluation and management of injuries to the hand/wrist during the 2-year study period were retrospectively identified...
March 2016: Orthopedics
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