Figure 10.

Diagram showing regional and statewide patient placement centers. Transfer centers interface with all hospital and health systems in a region or state and typically may be engaged after routine referral sources are no longer accepting transfers. Their role is to facilitate patient transfers quickly to an appropriate hospital setting including ICU and medical or surgical beds, while efficiently and effectively using capacity at both larger and smaller hospitals. The ability to pay should never be a criterion regarding transfer, and transfer centers should have policy authority to rotate transfers if required. Transfer distances may require a combination of ground and air transport. Intensivists and hospitalists may help to prioritize transfers based on both the type of (specialized) care needed and urgency of transfer, and they may be able to provide clinical advice to onsite clinicians whose patients may not be able to be transferred immediately.