Urgent interhospital transfers from regional hospitals

Vázquez Lima MJ, Álvarez Rodríguez C

Objectives: To analyze the resources available for urgent transfer of patients from regional

hospitals and the organization of those resources, and to determine the variables

related to the presence or absence of resources.

Methods: Descriptive, analytical study of 12 hospitals chosen by stepwise nonprobablistic

sampling. We determined the human resources available for patient transfers, the

organization of those resources, distance to the referral hospital, the number of urgencies

attended, the number of transfers accomplished, and the time spent in each

transfer.

Results: We detected excessive variation between regional hospitals with regard to the resources

available to them, the volume of urgencies attended, and size. Outside suppliers of

transport services were always used by 8.3% of the hospitals, whereas internal resources

were used by 58.3%. The remaining 33.3% used a combination of their own services and

outside suppliers. The hospitals that had their own staff for transferring patients used different

models to organize them. Some used on-call doctors and nurses, who were located

as needed, whereas others used staff in the course of their regular duties. The availability

or not of human resources was influenced by hospital size and distance from the referral

hospital.

Conclusions: Hospitals do not organize their human resources for patient transfers following

similar models, creating the impression that a model is lacking. The variability

cannot be explained by differences in resources and volume of urgencies attended in

the hospitals. The use of on-call personnel who are located to assist with urgent patient

transfers seems to be related to hospital size and distance from the referral hospital,

but not by the average time the transfer takes, the volume of urgencies attended, or

even the number of transfers required.

Vázquez Lima MJ, Álvarez Rodríguez C