Table 4.

Strategies utilized by transfer center nurses before and during three-way calls with referring and accepting providers

Strategy	Exemplary quotes
Prevent conflict through informational and emotional support	“Sometimes I find that our surgeons are maybe frustrated by receiving a call that doesn’t seem appropriate, and so I will let them vent to me. [Laughs]…. And I’m like, ‘Okay, get it all out. Are you done? Okay, now let’s go.’” (TCN 27)
	“They have a generally happy tone over the phone, like everybody’s all getting along, but then off the phone, like when they’re not talking to each other, it’s a little bit more like exasperation… we’re kind of the shoulders for a lot of doctors venting frustration.” (TCN 8)
Mediate conflict	“If they’re going back and forth we may interrupt and say, ‘Excuse me’ or ‘Can I get something else?’ just to sort of break the monotony and let them refocus. [Laughs] So I interrupt like, ‘Oh, by the way, can I get those vitals?’.… or, there have been times when we’ve had to say, ‘you know, this is a recorded line.’” (TCN 18)
	“Sometimes just a little practical talk goes a long ways…You just have to say, ‘Are you a little tired tonight, doctor?’…sometimes just give them a little hint.” (TCN 16)
Ensure complete information and solidify the plan for next steps	“We often interrupt while the doctors are talking to say, ‘Could we hear a set of vitals? Or could you send the images?’ if our physician forgets to do that.” (TCN 11) “I’m just like, ‘excuse me doctors I just want you to know we do have a waitlist’ or ‘we’re at capacity and there may be a delay for a bed.’ And I need both of them to know that because if it’s a situation where that’s not appropriate then we need to come up with a different plan.” (TCN 19)