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Interfacility transfer

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https://www.readbyqxmd.com/read/29133262/911-emergency-medical-services-and-re-triage-to-level-i-trauma-centers
#1
Eric Kuncir, Dean Spencer, Kelly Feldman, Cristobal Barrios, Kenneth Miller, Stephanie Lush, Matthew Dolich, Michael Lekawa
BACKGROUND: Interfacility transfer of under-triaged patients to higher level trauma centers has been found to result in a delay of appropriate care and increase in mortality. To address this, for the last 10 years, our region has utilized 911 EMS paramedics for rapid re-triage of under-triaged patients to our institution's Level I trauma center. We sought to determine if utilizing 911 EMS for re-triage (911-RT) to our institution was associated with worse outcomes-with mortality as the primary outcome-compared to direct EMS transport from point of injury...
September 27, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29067633/implementation-of-continuous-video-electroencephalography-at-a-community-hospital-enhances-care-and-reduces-costs
#2
Brad J Kolls, Brian E Mace, Keith E Dombrowski
BACKGROUND: Despite data indicating the importance of continuous video-electroencephalography (cvEEG) monitoring, adoption has been slow outside major academic centers. Barriers to adoption include the need for technologists, equipment, and cvEEG readers. Advancements in lower-cost lead placement templates and commercial systems with remote review may reduce barriers to allow community centers to implement cvEEG. Here, we report our experience, lessons learned, and financial impact of implementing a community hospital cvEEG-monitoring program...
October 24, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28870269/failure-to-communicate-transmission-of-extensively-drug-resistant-bla-oxa-237-containing-acinetobacter-baumannii-multiple-facilities-in-oregon-2012-2014
#3
Genevieve L Buser, P Maureen Cassidy, Margaret C Cunningham, Susan Rudin, Andrea M Hujer, Robert Vega, Jon P Furuno, Steven H Marshall, Paul G Higgins, Michael R Jacobs, Meredith S Wright, Mark D Adams, Robert A Bonomo, Christopher D Pfeiffer, Zintars G Beldavs
OBJECTIVE To determine the scope, source, and mode of transmission of a multifacility outbreak of extensively drug-resistant (XDR) Acinetobacter baumannii. DESIGN Outbreak investigation. SETTING AND PARTICIPANTS Residents and patients in skilled nursing facilities, long-term acute-care hospital, and acute-care hospitals. METHODS A case was defined as the incident isolate from clinical or surveillance cultures of XDR Acinetobacter baumannii resistant to imipenem or meropenem and nonsusceptible to all but 1 or 2 antibiotic classes in a patient in an Oregon healthcare facility during January 2012-December 2014...
September 5, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28860727/the-role-of-caregivers-in-interfacility-care-transitions-a-qualitative-study
#4
Lianne Jeffs, Marianne Saragosa, Madelyn P Law, Kerry Kuluski, Sherry Espin, Jane Merkley
A qualitative design was used to explore the nature of caregiver involvement in care transitions of patients being transferred from an acute care hospital to a rehabilitation hospital. Participants included older adults (n=13), informal caregivers (n=9), and health care professionals (n=50) from inpatient orthopedic units in two academic health science centers and one orthopedic inpatient rehabilitation unit. Semistructured interviews were conducted, audio-taped, and transcribed. Directed content analysis revealed the following four themes: watching, being an active care provider, advocating, and navigating the health care system...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28822393/identifying-futile-interfacility-surgical-transfers
#5
Kristy Kummerow Broman, Sharon E Phillips, Jesse M Ehrenfeld, Mayur B Patel, Oscar M Guillamondegui, Kenneth W Sharp, Richard A Pierce, Benjamin K Poulose, Michael D Holzman
Surgeons perceive that some surgical transfers are futile, but the incidence and risk factors of futile transfer are not quantified. Identifying futile interfacility transfers could save cost and undue burdens to patients and families. We sought to describe the incidence and factors associated with futile transfers. We conducted a retrospective cohort study from 2009 to 2013 including patients transferred to a tertiary referral center for general or vascular surgical care. Futile transfers were defined as resulting in death or hospice discharge within 72 hours of transfer without operative, endoscopic, or radiologic intervention...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28754811/consistency-of-pressure-injury-documentation-across-interfacility-transfers
#6
Lee Squitieri, David A Ganz, Carol M Mangione, Jack Needleman, Patrick S Romano, Debra Saliba, Clifford Y Ko, Daniel A Waxman
BACKGROUND: Hospital-acquired pressure injuries (HAPIs) are publicly reported in the USA and used to adjust Medicare payment to acute inpatient facilities. Current methods used to identify HAPIs in administrative claims rely on hospital-reported present-on-admission (POA) data instead of prior patient health information. OBJECTIVE: To study the reliability of claims data for HAPIs and pressure injury (PI) stage by evaluating diagnostic coding agreement across interfacility transfers...
July 28, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28743480/the-influence-of-insurance-type-on-interfacility-pediatric-emergency-department-transfers
#7
Chris A Rees, Stephanie Pryor, Ben Choi, Mamata V Senthil, Nicholas Tsarouhas, Sage R Myers, Michael C Monuteaux, Richard G Bachur, Joyce Li
BACKGROUND: Disparities exist in the care children receive in the emergency department (ED) based on their insurance type. It is unknown if these differences exist among children transferred from outside EDs to pediatric tertiary care EDs. OBJECTIVE: To compare reasons for transfer and services received at pediatric tertiary care EDs between children with private and public insurance. METHODS: We performed a secondary analysis of a multicenter survey of ED providers transferring patients to pediatric tertiary care EDs in three major U...
July 19, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28697156/transitions-of-care-the-presence-of-written-interfacility-transfer-guidelines-and-agreements-for-pediatric-patients
#8
Andrea Lynn Genovesi, Lenora M Olson, Russell Telford, Diana Fendya, Ellen Schenk, Theresa Morrison-Quinata, Elizabeth A Edgerton
OBJECTIVE: Every year, emergency medical services agencies transport approximately 150,000 pediatric patients between hospitals. During these transitions of care, patient safety may be affected and contribute to adverse events when important clinical information is missing, incomplete, or inaccurate. Written interfacility transfer policies are one way to standardize procedures and facilitate communication between the hospitals leading to improved patient safety and satisfaction for children and families...
July 11, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28673618/extracorporeal-membrane-oxygenation-and-interfacility-transfer-a-regional-referral-experience
#9
David N Ranney, Desiree Bonadonna, Babatunde A Yerokun, Michael S Mulvihill, Nawar Al-Rawas, Michael Weykamp, Rathnayaka M Gunasingha, Raquel R Bartz, John C Haney, Mani A Daneshmand
BACKGROUND: The number of adults referred to high-volume centers for extracorporeal membrane oxygenation (ECMO) is increasing. Outcomes of patients requiring transport are not well characterized, and referral guidelines are lacking. This study describes the experience and outcomes of a single high-volume center. METHODS: A retrospective study was performed that included adults undergoing ECMO between June 2009 and December 2015. Patient characteristics and outcomes were acquired from the medical record...
November 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28601830/interfacility-transfer-of-pregnant-women-using-publicly-funded-emergency-call-centre-based-ambulance-services-a-cross-sectional-analysis-of-service-logs-from-five-states-in-india
#10
Samiksha Singh, Pat Doyle, Oona Mr Campbell, Laura Oakley, Gv Ramana Rao, Gvs Murthy
OBJECTIVE: To estimate the proportion of interfacility transfers (IFTs) transported by '108' ambulances and to compare the characteristics of the IFTs and non-IFTs to understand the pattern of use of '108' services for pregnant women in India. DESIGN: A cross-sectional analysis of '108' ambulance records from five states for the period April 2013 to March 2014. Data were obtained from the call centre database for the pregnant women, who called '108'. MAIN OUTCOMES: Proportion of all pregnancies and institutional deliveries in the population who were transported by '108', both overall and for IFT...
June 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28559362/receiving-providers-perceptions-on-information-transmission-during-interfacility-transfers-to-general-pediatric-floors
#11
Jennifer L Rosenthal, Patrick S Romano, Jolene Kokroko, Wendi Gu, Megumi J Okumura
BACKGROUND: Pediatric patients can present to a medical facility and subsequently be transferred to a different hospital for definitive care. Interfacility transfers require a provider handoff across facilities, posing risks that may affect patient outcomes. OBJECTIVES: The goal of this study was to describe the thoroughness of information transmission between providers during interfacility transfers, to describe perceived errors in care at the posttransfer facility, and to identify potential associations between thoroughness of information transmission and perceived errors in care...
June 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28546453/familial-caregiver-and-physician-perceptions-of-the-family-physician-interactions-during-interfacility-transfers
#12
Jennifer L Rosenthal, Su-Ting T Li, Lenore Hernandez, Michelle Alvarez, Roberta S Rehm, Megumi J Okumura
BACKGROUND AND OBJECTIVES: Children with special health care needs (CSHCN) have frequent hospitalizations and high specialty care utilization. If they initially present to a medical facility not capable of providing their definitive care, these children often experience an interfacility transfer. This transition has potential to impose hardships on familial caregivers. The goal of this study was to explore family-physician interactions during interfacility transfers from the perspectives of referring and accepting physicians and familial caregivers, and then develop a conceptual model for effective patient- and family-centered interfacility transfers that leverages the family-physician interaction...
June 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28538650/consequences-of-pediatric-undertriage-and-overtriage-in-a-statewide-trauma-system
#13
Hilary A Hewes, Mathew Christensen, Peter P Taillac, N Clay Mann, Kammy K Jacobsen, Stephen J Fenton
BACKGROUND: With increasing attention to the quality of health care delivery, evaluating trauma triage decisions in a large system of emergency care can help decision makers reduce mortality, morbidity, unnecessary transfers, and health care costs. OBJECTIVES: To quantify the magnitude of pediatric traumatic injury undertriage (hospital mortality risk) and overtriage (early trauma center discharge after transfer) in a statewide trauma system. METHODS: A statewide population-based evaluation of pediatric trauma outcomes and secondary triage (interfacility transfers) patterns from 2001 to 2013 among 45 hospitals in Utah's statewide trauma system...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28536177/interfacility-transfer-directly-to-the-neuroangiography-suite-in-acute-ischemic-stroke-patients-undergoing-thrombectomy
#14
Ashutosh P Jadhav, Cynthia L Kenmuir, Amin Aghaebrahim, Kaustubh Limaye, Lawrence R Wechsler, Maxim D Hammer, Matthew T Starr, Bradley J Molyneaux, Marcelo Rocha, Francis X Guyette, Christian Martin-Gill, Andrew F Ducruet, Bradley A Gross, Brian T Jankowitz, Tudor G Jovin
BACKGROUND AND PURPOSE: In patients identified at referring facilities with acute ischemic stroke caused by a large vessel occlusion, bypassing the emergency department (ED) with direct transport to the neuroangiography suite may safely shorten reperfusion times. METHODS: We conducted a single-center retrospective review of consecutive patients transferred to our facility for consideration of endovascular therapy. Patients were identified as admitted directly to the neuroangiography suite (DAN), transferred to the ED before intra-arterial therapy (ED-IA), and transferred to the ED but did not receive IA therapy (ED-IV)...
July 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28499680/a-systematic-review-of-the-prevalence-and-types-of-adverse-events-in%C3%A2-interfacility-critical-care-transfers-by-paramedics
#15
Abdullah Alabdali, Joanne D Fisher, Chetan Trivedy, Richard J Lilford
OBJECTIVE: The aim of this study was to investigate if paramedics can safely transfer interfacility critically ill adult patients and to determine the prevalence and types of adverse events when paramedics lead interfacility critical care transfers. METHODS: MEDLINE, Web of Science, Embase, and CINAHL databases were searched from 1990 up to February 2016. Eligibility criteria were adult patients (16 years and over), interfacility transfer (between two health care facilities), quantitative or qualitative description of adverse events, and a paramedic as the primary care provider or the sole health care provider...
May 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28495830/establishing-recommendations-for-stroke-systems-in-the-thrombectomy-era-the-upstate-new-york-stakeholder-proceedings
#16
Zainab Magdon-Ismail, Curtis Benesch, Jeremy T Cushman, Ian Brissette, Andrew M Southerland, Ethan S Brandler, Cemal B Sozener, Sue Flor, Roseanne Hemmitt, Kathleen Wales, Krystal Parrigan, Steven R Levine
BACKGROUND AND PURPOSE: The American Heart Association/American Stroke Association and Department of Health Stroke Coverdell Program convened a stakeholder meeting in upstate NY to develop recommendations to enhance stroke systems for acute large vessel occlusion. METHODS: Prehospital, hospital, and Department of Health leadership were invited (n=157). Participants provided goals/concerns and developed recommendations for prehospital triage and interfacility transport, rating each using a 3-level impact (A [high], B, and C [low]) and implementation feasibility (1 [high], 2, and 3 [low]) scale...
July 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28490566/a-retrospective-cohort-study-of-the-utility-of-the-modified-early-warning-score-for-interfacility-transfer-of-patients-with-traumatic-injury
#17
Kristin Salottolo, Matthew Carrick, Jacob Johnson, Mark Gamber, David Bar-Or
OBJECTIVE: The modified early warning score (MEWS) is a 'track and trigger' score using routine physiological vital signs. The objective is to determine if the pretransfer MEWS can be used for predicting outcomes in trauma patients requiring interfacility transfer to higher levels of care. DESIGN, SETTING AND PARTICIPANTS: Retrospective study of consecutively transferred trauma patients into a level-II trauma centre from 2013 to 2014. INTERVENTIONS: None...
May 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28481163/body-temperature-after-ems-transport-association-with-traumatic-brain-injury-outcomes
#18
Joshua B Gaither, Vatsal Chikani, Uwe Stolz, Chad Viscusi, Kurt Denninghoff, Bruce Barnhart, Terry Mullins, Amber D Rice, Moses Mhayamaguru, Jennifer J Smith, Samuel M Keim, Bentley J Bobrow, Daniel W Spaite
INTRODUCTION: Low body temperatures following prehospital transport are associated with poor outcomes in patients with traumatic brain injury (TBI). However, a minimal amount is known about potential associations across a range of temperatures obtained immediately after prehospital transport. Furthermore, a minimal amount is known about the influence of body temperature on non-mortality outcomes. The purpose of this study was to assess the correlation between temperatures obtained immediately following prehospital transport and TBI outcomes across the entire range of temperatures...
September 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28350723/reasons-for-interfacility-emergency-department-transfer-and-care-at-the-receiving-facility
#19
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 aims of this study were to (1) assess the reasons for pediatric interfacility transfers as identified by transferring providers and review the emergency medical care delivered at the receiving facilities and (2) investigate the emergency department (ED) care among the subpopulation of patients discharged from the receiving facility. METHODS: We performed a multicenter, cross-sectional survey of ED medical providers transferring patients younger than 18 years to 1 of 4 US tertiary care pediatric hospitals with a subsequent medical record review at the receiving facility...
March 27, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28328689/adult-chest-pain-in-the-pediatric-emergency-department-treatment-and-timeliness-from-door-in-to-door-out
#20
Jeffrey H Sacks, Peter B Flueckiger, Philip R Spandorfer, William T Mahle, Brian E Costello
OBJECTIVES: The American College of Cardiology Foundation/American Heart Association guidelines for acute coronary syndrome (ACS) recommend immediate aspirin (ASA) administration, an electrocardiogram (ECG) in less than 10 minutes, and a door-in to door-out (DIDO) time less than 30 minutes for interfacility transfer. We sought to determine if compliance is hindered when adults with suspected ACS present to pediatric facilities. METHODS: Visits to the 2 tertiary care emergency departments of a pediatric healthcare system using an adult chest pain protocol were examined from October 2006 to September 2012...
November 2017: Pediatric Emergency Care
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