Case Presentation: Our patient is a 74-year-old male with a history of thrombocytopenia thought secondary to ITP, hypothyroidism, and prior spontaneous coronary artery dissection requiring cardiac bypass who was transferred from an outside hospital for acute kidney injury and abdominal distention. A few weeks prior to admission, the patient experienced congestion, cough and low-grade fever [...]

Background: Inter-hospital transfers are integral to a functioning health care network. Critical access, rural, and community hospitals established in sparsely populated territories are unable to support tertiary care infrastructure and rely on academic centers for consultation and transfer. Transfers comprise an estimated 3.5% of inpatient admissions (1), owing in part to increased procedural specialization concentrated [...]

Background: Interhospital transfer (IHT) processes vary across institutions. The fragmented and complex nature of IHTs pose patient safety risks. The implementation of a standardized IHT process with a templated note for hospital medicine patients at our institution demonstrated promising patient safety outcomes and a significant increase in physician satisfaction. A second, iterative intervention expanded this [...]

Background: Interhospital transfers (IHT) for additional care are a necessary, if high-risk, part of the healthcare system. Return transfers, in which the patient is returned to the referring hospital once higher-level care is no longer needed, are also a part of the healthcare system but are even more varied and less systematized and studied within [...]

Background: Outside-hospital (OSH) transfers are crucial to providing patients with a higher level or more specialized care. Despite the intent to improve care, OSH transfers are associated with negative outcomes due to miscommunication, lack of information, and other factors affecting patient care. Currently, there is no widely standardized process for OSH transfers. Studies show that [...]