Interhospital patient transfer
Formal Definition
The structured process of physically moving a patient from one hospital to another for ongoing medical care, encompassing clinical handoff (verbal communication via SBAR or I-PASS between sending and receiving teams), documentation transfer (current meds, recent labs, imaging, active problems, code status), physical logistics (bed confirmation, transport team, mode of travel), regulatory/administrative compliance (EMTALA obligations, insurance authorization, patient consent), and continuity of care planning to ensure the receiving team has full context to assume care without missing critical issues; categorized by clinical urgency (routine vs urgent vs emergent vs time-critical like stroke or STEMI).
How It's Used on the Ward
"Interhospital transfer" or "transfer" — sending a patient from one hospital to another for ongoing care; this is distinct from intrahospital transfer (moving a patient from one unit to another within the same hospital, e.g., floor to ICU) and from ED-to-ED transfers; interhospital usually involves calling a transfer center, getting acceptance, coordinating transport, and ensuring the receiving team has everything they need once the patient arrives.
Example
""62-year-old post-op day 2 from emergent exploratory laparotomy at rural hospital, dehisced overnight, transported to regional academic medical center for wound vac management and potential re-exploration. Sending surgical team calls receiving surgery team at 0700 with structured SBAR handoff — current ICU status, lines/drains/antibiotics/pain regimen, recent labs (WBC 19, lactate 1.8, hgb 8.4 post-transfusion), wound status, family situation, code status. Transfer center arranges ground critical care transport at 1030, with flight team standby if weather allows faster helicopter option. Patient arrives at 1300 to receiving surgical ICU with full records and imaging on compact discs.""
Clinical Context
Critical components: (1) Clinical handoff — verbal SBAR or I-PASS between sending and accepting physicians; receipt confirmed. (2) Documentation — current meds (especially infusions — pump settings, last titrated dose, time), recent labs, active problems list, code status/advance directives, allergies, recent imaging on transferred CDs or accessible via cloud PACS. (3) Lines/drains — current IV access, Foley, surgical drains, NG/OG tubes, central lines, arterial lines documented with insertion date and last dressing change. (4) Logistics — accepting physician and bed assignment confirmed, transport mode (ground ambulance, CCGT critical care ground transport, rotor-wing helicopter for distances <150 miles, fixed-wing for longer distances), ETA communicated. (5) Family — informed consent, family aware and ideally able to travel to receiving hospital, contact information exchanged. (6) Regulatory: EMTALA (Emergency Medical Treatment and Labor Act) — patient must be stabilized within sending hospital's capability prior to transfer, with documented medical indication, accepting physician confirmation, and appropriate transport mode; insurance authorization obtained when feasible. Receiving team should perform full re-evaluation regardless of sending team's notes (things change during transport).