Processes and support tools for interhospital neonatal patient transfer: A preliminary study

There has been a growing interest in interhospital patient transfers. However, much of this research has focussed on the criteria for transferring patients; very little research is available about the transfer process itself. The purpose of this preliminary study was to describe the process and support technology used to transfer neonatal intensive care patients from metropolitan and rural hospitals to Vanderbilt Children’s Hospital (VCH). Three patient transfer events were observed using ethnographic observational methods. One researcher observed processes at VCH while a second researcher accompanied the transport team. Data from both perspectives were collated and integrated. The resulting process model shows that patient transfers are complex, highly choreographed processes involving three leaders. Multiple modes of technology are used for very different purposes. Areas of potential vulnerability include leader inexperience, the use of paper forms by multiple leaders and complexities associated with the convergence of parallel processes. Directions for future research are suggested.