203 posters, 14 topics, 5 sessions, 817 authors, 256 institutions

The AAPS 102nd Annual Meeting

May 18-21, 2024 | The Westin Copley Place, Boston, MA

D132

Improving Patient Transfer Quality With A Dedicated Transfer Center In An Emergency Setting: The Example Of A Digital Replantation Program

Preview of Improving Patient Transfer Quality With A Dedicated Transfer Center In An Emergency Setting: The Example Of A Digital Replantation Program

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Poster Presenter

Virginie Arsenault

Authors

Virginie Arsenault, Jenny C. Lin, Frédéric Lavoie, Marie-Ève Desrosiers, Michel A. Danino

Affiliations

University of Montreal, Department of Plastic and Reconstructive Surgery, Centre Hospitalier de l’Université de Montréal (CHUM), Department of Orthopedic Surgery, Centre Hospitalier de l’Université de Montréal (CHUM), Centre Hospitalier de l'Université de Montréal (CHUM)

Part of Topic

Education/Practice Management/Other

Improving Patient Transfer Quality with a Dedicated Transfer Center in an Emergency Setting: The Example of a Digital Replantation Program

Introduction

Centralization to trauma centers has become the gold standard for management of severe traumatic injuries.1,2 For upper extremity injuries, transfers to specialized centers have been associated with better outcomes in terms of digital survival, hand function, aesthetic appearance and patient satisfaction.3

Unnecessary transfers, secondary to incomplete data collection, unclear transfer indications or poor communication, burden the trauma network4 :

•Important transportation costs

•Unnecessary mobilization of the care team and hospital resources

•Time consuming and stressful for the patient

Since 2004, an expertise center in replantation of the upper extremity was developed in our institution and covers 1,5 million km2 and 8,5 million population5.

In 2019, a dedicated transfer center was added to facilitate transfer management:

- 24/7 call center managed by specialized nurses

- Standardized collection of relevant patient information, clinical photography and radiographic imaging

- Coordination of interhospital transfers and phone support to the referring hospital

- Standardized recorded discussions established by an intermediary from the transfer center between transferring and receiving doctors

Objective

Assess the impact of implementing a dedicated transfer center on the number of avoidable patient transfers to a centralized quaternary care center for upper limb replantation and revascularization.

Materials and Methods

•Study design and data collection:

- Retrospective analysis of all transfer requests between Sep 2017–Dec 2021

- Patient selection was made within two years of the implementation of the transfer center (2019) to allow comparison (before vs after)

- Epidemiology, injury characteristics and transfer outcomes were collected for all transfer requests

•Outcome assessment:

- Useful transfer: microsurgical vascular procedure or exploration was performed

- Avoidable transfer: no microsurgical vascular procedure was necessary or possible

•Statistical Analysis: using SPSS Statistics software
chi-square test and independent samples t-Test

Results

•795 transfer requests were included (88% male, mean age of 49yo)

Following the implementation of a dedicated call center to the transfer center:

•Transfer requests increased from 13,5 to 17 requests/month (p= 0,016)

•Refused transfer requests increased by 9% (p= 0,009)

•Avoidable transfers reduced by 7,3% (p= 0,047)