Interhospital transfers in a non-tertiary hospital-does it improve with formal training?

By:

Khalil, J

Contributor(s):

Kovari, F

Publication details: 2016Uniform titles:

Intensive Care Medicine Experimental

Online resources:

Click here to access online

Summary: The aim of this audit was to demonstrate any significant improvement in our inter-hospital transfer practice following the introduction of a new simulated all day training provided to junior doctors in the view of auditing our transfer data from 2014–2015.A single centre retrospective audit in 21 bed mixed ICU of a non-tertiary university hospital. During the audit period (2014–15) 29 critical care transfers were made. We audited data of referring team, location, receiving team, transfer reason, decision-departure time, intubation details, arterial blood gases (ABG), comments of the teams, time of transfer, documentation and transferring doctor grade. Our primary aim was to analyse any effect of our newly introduced complex transfer training program.In 2014, transfers were by SHO level doctors 38.5 % of cases, staff grade and registrar level doctors were 46.1 % each, 15.3 % were not documented.In 2015, transfers were by SHO level doctors 6.25 % of cases, staff grade and registrar level doctors were 93.7 % each. All transfers were documented.Non-clinical reasons in 2014 were 24 % opposite zero non clinical transfers in 2015. In 2014 (53.8 %) of transfers occurred outside normal working hours (8 am to 17:00) versus 56.25 % in 2015, unlike the past where most of transfers usually happened outside the normal working hours.Transfer- decision to departure time varied, with an average time of minutes In 2014 the average time in minutes was 229 minutes which was nearly double its peer value in 2015 (133 minutes).Records of the doctor performing the transfer were well kept but those of the receiving team were generally absent but thanks to the new transfer form 24 out of 29 comments from the receiving team were documented (82.7 %) and were consistent with the expectations with one comment saying (Excellent handover).The transfer of the critically ill patients remains a big challenge to juniors of all grades. A complex and holistic approach needed with a broad spectrum of knowledge regarding the possible complications.Our all day transfer course introduced in 2015 gave the opportunity to learn and hands on simulate with a live ambulance what is it like to be on a hot transfer.Our data shows significant improvement in the documentation, organization and quality of transfer without adverse events affecting patient´s safety with lack of incident reports.The positive feed backs from trainees and the overall improvement of our transfer service proves that simulated training of this difficult and grey area is fruitful and worth carry on.

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Item type	Home library	Collection	Class number	Status	Date due	Barcode
Book	Ferriman information and Library Service (North Middlesex) Shelves	Staff publications for NMDX		Available

NMUH Staff Publications

EMBASE

The aim of this audit was to demonstrate any significant improvement in our inter-hospital transfer practice following the introduction of a new simulated all day training provided to junior doctors in the view of auditing our transfer data from 2014–2015.A single centre retrospective audit in 21 bed mixed ICU of a non-tertiary university hospital. During the audit period (2014–15) 29 critical care transfers were made. We audited data of referring team, location, receiving team, transfer reason, decision-departure time, intubation details, arterial blood gases (ABG), comments of the teams, time of transfer, documentation and transferring doctor grade. Our primary aim was to analyse any effect of our newly introduced complex transfer training program.In 2014, transfers were by SHO level doctors 38.5&nbsp;% of cases, staff grade and registrar level doctors were 46.1&nbsp;% each, 15.3&nbsp;% were not documented.In 2015, transfers were by SHO level doctors 6.25&nbsp;% of cases, staff grade and registrar level doctors were 93.7&nbsp;% each. All transfers were documented.Non-clinical reasons in 2014 were 24&nbsp;% opposite zero non clinical transfers in 2015. In 2014 (53.8&nbsp;%) of transfers occurred outside normal working hours (8&nbsp;am to 17:00) versus 56.25&nbsp;% in 2015, unlike the past where most of transfers usually happened outside the normal working hours.Transfer- decision to departure time varied, with an average time of minutes In 2014 the average time in minutes was 229&nbsp;minutes which was nearly double its peer value in 2015 (133&nbsp;minutes).Records of the doctor performing the transfer were well kept but those of the receiving team were generally absent but thanks to the new transfer form 24 out of 29 comments from the receiving team were documented (82.7&nbsp;%) and were consistent with the expectations with one comment saying (Excellent handover).The transfer of the critically ill patients remains a big challenge to juniors of all grades. A complex and holistic approach needed with a broad spectrum of knowledge regarding the possible complications.Our all day transfer course introduced in 2015 gave the opportunity to learn and hands on simulate with a live ambulance what is it like to be on a hot transfer.Our data shows significant improvement in the documentation, organization and quality of transfer without adverse events affecting patient´s safety with lack of incident reports.The positive feed backs from trainees and the overall improvement of our transfer service proves that simulated training of this difficult and grey area is fruitful and worth carry on.&nbsp;

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