Trauma Transfers: A Retrospective Analysis of Multiple Transfers

Indianapolis, IN

Traumatic injuries are the leading cause of death in young adults. When traumatic injuries occur, the first hospital that a patient arrives at may not be able to provide a necessary level of care. When this happens, the patient may need to be transferred one or more times. Although most transfers benefit the patient, when they happen unnecessarily it consumes time and resources. An abnormally high number of duplicate transfers may be a sign of inefficiencies in a healthcare system. This study examined the potential reasons why District 3 constituted 66% of double transfers within Indiana’s Trauma System between 2014 and 2016. This study analyzed cases of 170 double transfer patients from District 3. Data were analyzed with and without inter-hospital transfers occurring on the same campus. Patients with an Injury Severity Score (ISS) greater than 15 were found to be more likely to be transferred to receive specialty care than patients with an ISS less than 15. The time it took for patients to be transferred a second time was not related to ISS. Once inter-hospital transfers to a hospital on the same campus were removed, 86% of the cases were deemed appropriate transfers. The high percentage of double transfers in District 3 were attributed to transfers to a specialty hospital on the same campus as the initial hospital. It is recommended that transfers occurring on the same campus are not reported as duplicate transfers to the Indiana Trauma Database, to better represent the transfers in District 3.