Hospitals are increasingly setting up "transfer centers" to coordinate the logistics involved in moving patients, whether from the scene of an accident, a community hospital for more specialized care or a physician's office.
University Hospital established a transfer center more than two years ago, but it's still a work in progress, constantly improving, according to Seari Hulse, clinical nurse coordinator.
It's Utah's first, but not only, transfer center, where staffers take physician referral calls relating to consultation, patient admission and more. If a doctor needs to talk with a specialist, they make it happen. If a physician says his patient needs to be seen right away, they make that happen, too. They're the "need-it-now" folks who simplify what has sometimes been a bottleneck-prone process.
The U. center has 14 employees, most of them nurses or emergency medical technicians. The center's staffed around the clock, although they only handle urgent-need cases. Situations that can wait for a regular clinic are not what they are there for.
"If a doctor has a patient who needs to be seen right away, we help with that. We all have quite a bit of experience with patient care, so we can help triage and prioritize patient needs. We're familiar with the diagnoses and are each trained so we're familiar with the way the system works," Hulse said.
Hospitals aren't the only ones involved with transfer centers. One Salt Lake-based company was formed because an internal medicine physician, Dr. Darin Vercillo, recognized that need. Central Logic Healthcare Systems was formed to create a program to smooth the transfer process, save lives and enhance health care, Vercillo, the president and CEO, said. He calls it key to running an efficient, cost-effective and profitable health-care facility.
The company's software is called ForeFront Transfer. They also launched a Web site called TransferCenters
.org as a resource to transfer center directors, hospital administrators and others who want to share what works and what doesn't as they help each other build robust transfer centers.
The concept of transfer centers started about eight years ago, but has recently "ramped up," Vercillo said. And center success is showing up in places like patient quality-of-care measures. If someone with pneumonia can get in and treated with antibiotics without delays, in a simple process, they're happier and the results are better. If it's easier to get someone who's having a heart crisis to a larger facility that has the right expertise and equipment, everyone benefits, he said.
It's also a way to cut down waiting times in emergency departments. A physician can call from his office and have the patient admitted directly. The software program pays for itself quickly, he said.
In some parts of the country, there are now larger transfer centers that coordinate patient movement for 20 to 40 hospitals.
It's not all perfect. Hulse said the U. transfer center hasn't yet embraced all the technological support they'd like in order to document what they do in real time. They still have both paper charts and a database they came up with in Microsoft's Access program. There's sometimes a time lag.
But they're doing what all transfer centers are designed for: Smoothing the way as patients are moved around within the health-care system. At St. Alphonsus Hospital in Boise, the transfer center is the central access point for all patient transfers into the hospital, coordinating based on factors like physician availability, clinical diagnosis, bed availability and transport method. They've consolidated some of their divisions, including their air ambulance, physician on-call scheduling, physician consultation resources, bed control and urgent patient admissions.
A transfer center's benefit to the referring physician or facility is easy to spot. With a single phone call, a referring physician can be put in touch with a specialist if needed, and center staff will find a physician to accept a patient, make arrangements to get the needed bed, handle all communication with the referring facility, coordinate time and type of transfer and more. The U. team can contact AirMed dispatch and have an ambulance in the air while they're still on the phone with the physician, Hulse said.
"Our goal is that (the person referring) only has to make one call. We'll do the rest. And if our specialists will take one call, we'll do the legwork to simplify things."
It's a process that's been getting smoother and reaching ever farther, she said. They've been involved in international transfers from as far away as China, Egypt, Germany and Afghanistan.The online forum is at www.TransferCenters.org. Central Logic is online at www.centrallogic.com.