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: 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: Advances in technology and life-sustaining interventions afford patients access to a wider network of subspecialized care through inter-facility transfers. Implicit in these transfers are multiple complex steps that leave patients vulnerable to adverse events. The few guidelines that exist regarding the inter-facility transfer process focus on critically-ill or surgical patients, and emphasize pre-transfer communication [...]

Background: With the recent consolidation of hospital systems and the increasing complexity of inpatient care, receiving inter-hospital transfers (IHT) has become more common for large academic medical centers. Notably, studies have shown IHT to be associated with increased length of hospital stay (1,2), increased cost of care (2,3), as well as delays in care and [...]

Background: Interhospital transfer (IHT), which is often performed to provide patients with necessary procedural and specialized care, is a common occurrence in modern healthcare. Racial/ethnic inequities in IHT have been described using nationally representative data, however such inequities have not been characterized at a more local level, which can provide more granular data to adjust [...]

Background: The transfer of patients between hospitals, known as inter-hospital transfer (IHT), is associated with higher rates of mortality, longer lengths of stay, and higher hospitalization costs compared to admissions from the emergency department. Despite these poor patient outcomes, best practices to guide IHTs are lacking. To characterize the IHT process and identify key challenges [...]

Background: Interhospital transfer (IHT) is intended to improve access to specialized therapies, maintain continuity of care, or care concordant with patients’ wishes; however, it is correlated with higher costs, longer length of stay, and greater mortality for many patients, even after illness severity adjustment (1-5). A better understanding of frontline providers’ reasons to accept transfer [...]

Background: The transfer of patients between hospitals, i.e., interhospital transfer (IHT), introduces discontinuity of care including gaps in information transfer, which may worsen patient outcomes. In this study we aim to identify gaps in information exchange during IHT of medical patients from transferring hospitals of varying affiliation and electronic health record (EHR) integration to a [...]

Background: Inter-hospital transfer (IHT) care is complex and suffers from inefficiencies in information and task organization, which can contribute to high cognitive load for clinicians.[1-4] Cognitive overload can lead to medical errors and clinician stress.[5-8] Our study identifies specific areas of high cognitive load experienced by hospital medicine physicians and advanced practice providers (APPs) who [...]

Background: Interhospital transfer (IHT) is a pathway by which many patients may receive procedures or specialty care not available at their local hospital. While IHTs present the opportunity for resource sharing between hospitals for the purpose of improved patient outcomes, the discontinuity of care and the acuity of the patients may adversely affect other quality [...]