The dynamics around patient access to timely care and treatment continues to grow in complexity for healthcare systems globally. Patient populations are rising, increasing the flow and volume passing through hospitals and other care facilities at faster and faster rates. Incidences of patients being delayed access to critical medical treatment due to facility capacity -- or receiving care at facilities not specializing in a particular condition or illness -- has been an issue that is becoming increasingly more prevalent. Very often, the underlying driver for “misplaced” patients and less-than-optimal patient placement decision-making is a lack of real-time visibility into available beds.
The problem painfully highlights the historically unequal and unstandardized approach towards and the development of what has emerged as the most critical entry point for patient care in health systems today – the hospital transfer center. Transfer center operations have become one of the most important determinants of how and when patient care will be delivered, as well as a key forecaster of a health system’s financial growth. As health system and hospital consolidation continues to increase, patient volume pressures on transfer center operations will likewise rise; therefore, achieving efficiencies will be a paramount priority for ensuring the viability of transfer centers in the future.
Foundational flaws and inefficiencies
in transfer center processes can result in patient flow breakdowns and heightened risk to patient care and safety due to delays in receiving treatment. For instance, often because the communications and placement negotiation process are slow and inefficient, a care space that may have been identified as available can quickly become unavailable and the facility must scramble to send a patient elsewhere – plus there may be a wait involved to complete the placement.
In many cases, transfer center patient placement decisions are currently made on a diffused basis, i.e., by individual hospitals or care facilities, versus from a centralized vantage point at a health system level. In addition, many individual facilities within a health system have multiple transfer centers with different processes and cultures that include a competitive vs. a collaborative approach to securing patient transfers (it’s my patient vs. it’s our patient). This leaves the entire transfer center ecosystem in the U.S. in a weakened state where wide margins of error in moving patients to where they can be treated - even when it may not always be possible to send them to where they should be treated - will be challenging to address.
In many instances, deficiencies in transfer center operations may be linked to poor visibility into care capacity options, lack of inter-facility communications or a combination of both; while in other instances, the cause may be transfer center policies that have never been reevaluated to determine if changes are necessary. One example is a health system that has always sent an accepted patient transfer from an outside hospital to a tertiary care facility instead of one of its own hospitals where the treatment could have been delivered. However, if a tertiary care location is at full capacity and/or a far distance from the patient’s residence, the delay in that patient’s placement could potentially have serious consequences. Transfer center operations will continue to be vulnerable unless assumed practices are assessed and there is a shift away from individual facility autonomous patient transfer management to collaborative cross-facility patient placement communications and decision-making.
Additionally, while transfer centers are a primary access point for patient movement, their optimized operations may be dependent on how well other health system patient entry, throughput and discharge flows are working. If, for instance, ED and scheduled procedure patients are efficiently assigned inpatient beds and then treated with best clinical practices and discharged from a care facility, that opens more capacity for that facility to receive more transfer patients. Likewise, a highly developed transfer center can identify more options to alleviate patient volume pressures when a hospital is nearing full capacity. To that end, patient census and continually updated registration and discharge projection data can be a particularly helpful and valuable tool for sharpening transfer center operations.
With financial pressures mounting, health systems simply cannot afford to have inefficient and poorly performing transfer center processes. Furthermore, weak transfer centers can be a significant cost drag with transport resources like ambulances, helicopters and other modes going underutilized and requiring expensive maintenance for their upkeep. Fixing transfer center staffing and communications deficiencies, as well as having a system to capture data around transfer operations processes so healthcare organizations know what and how to improve them, are the key steps to making the promise of transfer center benefits a reality, and it starts with having the proper technology to do so.
While patient transfers from one facility to another are often still negotiated on an ad-hoc basis between facilities without secure knowledge that a patient care location is available and/or is the right setting based on the patient’s status or therapeutic need, many healthcare organizations are increasingly moving to automated, centralized transfer and transport center models with supporting operational technology platforms to address the range of patient placement blind spots. The goal for these health systems is to stand up efficiently run transfer centers that allow for the controlled identification, entry and exit of patients to appropriate care settings across and between their and other care networks of hospitals and alternative treatment sites.
Cloud-based transfer center operational platforms like TeleTracking's TransferCenterIQ™ allow healthcare organizations to significantly mitigate, and even eliminate in many cases, the patient placement errors and inefficiencies inherent in manual or partially automated application-based processes. Health systems and hospitals that have implemented TeleTracking’s TransferCenterIQ ™ are realizing significant benefits and outcomes. Examples from a cross section of our clients have included:
- Transfer patient revenue contributions across therapy categories average from more than $3 million (cardiology) to more than $12 million (neurosurgery)
- 15-20% average increase in patient volume
- Patient transfer volume increase from 327 to 540 transfer requests and patient placements from 540 to 829 in one month
- Double-digit inpatient growth from non-health system referrals on every campus
- 25% faster arrival of air/ground transport to bedside
- 30% increase in utilization of health system transport assets
- A quadrupling of accepted patient transfers from more than 4,000 to 16,000
- A decreasing patient transfer decline of more than 200
- One phone call transfer coordination
- One-touch EMS/ambulance dispatch
- Increases in physician patient transfer referrals
The current state of unequally developed transfer center operational models with major blind spots into optimized patient placement decision making across the U.S., and around the world, potentially poses one of the largest threats to the continued delivery of best practice clinical care and health outcomes to patients. Poorly operated transfer centers also can lead to widening disengagement within and between referring physicians and care teams across treating facilities as trust and coordination in the patient transfer process breaks down. Manually or partially automated processes, such as multiple workflow and telephony applications that cannot share data, also impede health systems from developing a long-term strategy for generating revenue growth from transfer center operations that can be driven by senior leadership.
The promise of the transfer center for the sustainability of healthcare delivery as well as future health system financial growth rests on hospital and care facility adoption of automation platforms that accelerate the efficiencies of transfer processes. With technologies like the TeleTracking TransferCenterIQ™ platform, the entire healthcare ecosystem can have increased confidence that every hospital and patient care facility can receive, send and place a patient with little to no delay to get the treatment they require in the hour of their greatest need.