SP10.1.7 Assessment of interhospital transfers of acute surgical patients within an NHS trust

Abstract

Acute surgical services at our trust were moved from two sites to a single site, due to COVID-19. This project was inspired by cases of transfer whereby significant time delays resulted in poorer patient clinical outcome.

Aims

• To assess the times and delays in the transfer of an acute surgical patient at Site A to Site B for either continuing or definitive surgical intervention

• To assess the risks to patient safety and patient outcomes resulting from transfer

• To assess whether NCEPOD guidance for urgent surgery were adhered to

Methods

• Total transfers were audited over a three month period. The following parameters were recorded:

  1. Patient demographics

  2. Time patient referred to on call surgical team at Site A

  3. Time patient seen by on call surgical team at Site A

  4. Times to diagnosis and subsequent decision to transfer

  5. Time patient reached Site B

  6. Any procedure or operation or higher lever treatment the patient received

  7. Length of stay

  8. Any complications noted during inpatient stay

Results

Total cases of transfer	188
No. cases that went for CEPOD	78
No. of cases for procedures of any sort	99
Complications post/during procedure	37
Deaths	7
Average time from decision to transfer until arrival time at Site B	11:11
Average decision to transfer until procedure time	46:54

Average time from decision to transfer until arrival time at Site B	11:11
Average decision to transfer until procedure time	46:54

Conclusion

Interhospital transfer must focus on maintaining optimal health and outcomes for the patient. A guideline and framework for safe transfers must be implemented and adhered to strictly.