Background: Interhospital transfer is a poorly understood transition of care that is associated with increased length of stay and mortality. The processes and communication between transferring and accepting facilities and providers are not standardized.
Purpose: Hospitalist faculty education on triage processes is an area for potential intervention to improve interhospital transfer. New faculty hires are key targets for educational intervention as we hypothesize that there is limited formal education on triage and health systems often have complex transfer processes.
Description: We employed 3 different tailored presentations on the interhospital transfer triage process for new faculty at three tertiary academic medical centers. The presentations had varying degrees of depth and focus on process logistics, clinical reasoning regarding patient disposition, and communication tools. We studied the intervention with a retrospective survey of pre- and post-intervention knowledge and confidence in the transfer triage process. Of 21 faculty surveyed, only 29% had previous experience in triaging interhospital transfers. Eighty-six percent indicated none to low knowledge prior to the intervention versus 71% noting moderate to high knowledge after the presentation. Confidence in ability to triage improved from 90% having none to little confidence to 62% having moderate to high confidence. All respondents felt that the intervention was helpful with 62% indicating it was very or extremely helpful. Respondents who attended the more in-depth presentations were more likely to report moderate to high knowledge post presentation and were more likely to consider their experience extremely helpful.
Conclusions: New hospitalist faculty with limited experience in interhospital transfer triage may have a negative effect on quality and patient safety in tertiary care centers. A brief educational intervention tailored to the institution appears to have a meaningful impact on knowledge and confidence in the complex process of interhospital transfer triage.
