Background: The transfer of patients between hospitals (interhospital transfer, IHT), exposes patients to risks of discontinuity of care. In this study, we aim to better understand which patients may (or may not) benefit from IHT by evaluating the impact of IHT on clinically important patient outcomes among a variety of patient diagnoses. Methods: We performed [...]

Background: The transfer of patients between hospitals (interhospital transfer, IHT), exposes patients to risks of discontinuity of care. In this study, we aim to better understand which patients may (or may not) benefit from IHT by evaluating the impact of IHT on clinically important patient outcomes among a variety of patient diagnoses. Methods: We performed [...]

Background: Sub-optimal communication during care transitions contributes to poor patient outcomes. Patients who undergo interhospital transfer (IHT, the transfer of patients between hospitals) are at especially high risk given their level of illness severity. In examination of the IHT process at Brigham and Women’s Hospital (BWH), a 740-bed tertiary care referral hospital, we previously found [...]

Background: The transfer of patients between hospitals (interhospital transfer, IHT), exposes patients to risks of discontinuity of care, such as errors in communication and gaps in information transfer. In this study, we aim to quantify clinician-reported medical errors attributable to incomplete communication/information transfer during IHT to a tertiary referral hospital. Methods: We included all patients [...]

Background: Inter-hospital transfer (IHT, the transfer of patients between hospitals) exposes patients to risks of discontinuity of care. To identify aspects of the transfer process that increase risk, we examined the impact of select transfer process factors on clinical outcomes among patients undergoing IHT. Methods: We performed a retrospective analysis of patients ≥ age 18 [...]

Background: Approximately 1.6 million patients are transferred between hospitals yearly, with disproportionately high cost and mortality. Despite the risk associated with inter-hospital transition of care, there is no established best practice in coordinating and triaging transfers. This gap in knowledge is partly driven by a dearth of studies which integrate clinical data before and after [...]

Background: Poor communication among providers is a barrier to seamless transitions in patient care. This problem is compounded when patients undergo interhospital transfer (IHT), where complex patients are transferred between providers, settings and healthcare systems. Templated notes have been used in other hospital-based care transitions to improve communication but have not been widely utilized during [...]

Background: ST-segment elevation myocardial infarctions (STEMI) is a significant cause of morbidity and mortality in the United States. Inter-hospital transfers (IHT) are becoming the standard for treatment of ST-elevation myocardial infarctions (STEMIs) as specialized care is often concentrated at tertiary centers. The American Heart Association and the American College of Cardiology (AHA/ACC) recommends door-to-balloon time [...]

Background:  A small population of patients disproportionately consume an increasing share of medical resources.  These super-utilizers often have complex medical and psychosocial conditions that require carefully coordinated, individualized care.  As this population drives unplanned readmissions, programs to reduce readmissions may create unintended incentives to direct super-utilizers to another hospital system.   This study was designed to [...]

Background:  Transitions of care, whether between or within institutions, are an important source of errors, inefficiency, and unnecessary costs.  Inter-hospital transfers are complicated by incongruent information systems, indirect and asynchronous communication, and geographical distance all in settings of high patient complexity and acuity.  We developed a large database of patients transferred between hospitals to identify [...]