When a patient needs to be admitted for acute care but their local hospital doesn’t have enough room, Intermountain’s Transfer Center can step in to help find that patient a bed at another hospital. The Transfer Center can also help move a patient from a community hospital to a larger facility for advanced treatment. As many hospitals across Utah were often near capacity this winter due to the pandemic, the center’s work was more vital than ever.
Nan Nicponski
Caregivers at the Transfer Center have a birds-eye view of Intermountain’s capacity at a systemwide level, which helps inform decisions about patient placement and the appropriate level of care—an especially critical need when there’s high demand for beds. For example, if the ICU at Intermountain Medical Center has five acute patients expected to arrive, but only three available beds, the Transfer Center can coordinate and transfer any patients who are doing well or who would receive the same benefits of care at a community facility, such as LDS Hospital.
“This winter during the COVID-19 surge there were times when our ICUs were completely full or nearly full, and the coordination of transfers at a system level helped us maintain capacity and save lives,” says Nan Nicponski, executive director over the Transfer Center. “It allowed us to identify when and where we could take the most critical patients and when it made sense to transfer less acute patients to community hospitals or facilities closer to home.”
Nan says the Transfer Center works closely with TeleCritical Care and TeleHospitalist physicians and local facilities to place patients in the most appropriate care setting. “The purpose is to preserve capacity so that no one hospital is overwhelmed, while load balancing across the system,” says Nan.
For example, the Transfer Center was able to “level load” 498 patients over the past eight months to make room for more critical cases. These transfers occurred primarily at Intermountain Medical Center where less acute patients were sent to nearby hospitals.
“These transfers have helped us maintain open ICU beds, so we’d have capacity when a more critical patient needed us,” says Nan. “While we’d prefer not to move patients from one hospital to another, being able to ‘level load’ has benefits. If a provider needs a patient transferred, they know they can work with us on the appropriate placement. In addition, our team looks closely at whether a patient can receive the same care at their facility close to home, reducing stress on tertiary sites.”
Nan says, “Whether it’s finding a bed for a COVID-19 patient or another ICU patient, the center works with a standardized, accurate process based on actionable data to make decisions. This helps increase our response time when a transfer request comes in. We’ve also had good feedback from physicians on both sides, from sending to receiving patients.”
Katie Thomas, MD
“The Transfer Center has been invaluable in helping us continue to provide optimal, comprehensive care for all of our patients, including during our COVID surge,” says Katie Thomas, MD, a neurologist at Intermountain Medical Center. “Because of their commitment to collaboration and innovation, we’ve been able to improve the communication among providers and facilities and therefore elevate the level of service we provide as caregivers.”
The Transfer Center, which has been operating in-house since May 2019, has learned from past challenges to get where it is today. The service was outsourced in 2017 and during that time period there were treatment delays, inappropriate placement of patients, and frustration on the part of referring providers. Today, it functions as part of Intermountain’s enterprise-level virtual hospital, which combines all clinical telehealth services with provider support services to manage the logistics of patient movement through the system.
Here’s more about how the Transfer Center works:
- Real-time tracking. Transfer Center caregivers have access to a digital tracking board that shows all available beds within every Intermountain hospital. This is especially critical in ICUs, EDs, medical/surgical, and behavioral health units where there is higher care demand.
- Appropriate placement. The Transfer Center is staffed 24/7 with RNs and patient placement specialists as well as telehealth critical care and telehealth hospitalist physician “quarterbacks” who triage patients and determine bed placement in close partnership with hospital teams. The Transfer Center also coordinates with local facilities, ambulance crews, and Life Flight for transport.
- Improved decision-making. “It used to be that a provider would call us, say, near the Utah-Nevada border, and ask to transfer a critical patient to IMC,” says Nan. “Today we manage those transfers more effectively by sharing resources and determining the best course of action for each patient. When a physician calls into the Transfer Center a triage nurse and physician quarterback will inquire about the patient’s symptoms to determine where to send them. In some cases that patient would do well at a community hospital closer to home with telehealth services.”
- Transfers and volumes: The center has seen a significant jump in patient transfers since January 2020, says Nan, with an increase of nearly 20 percent more transfers in January 2021 due to the pandemic. In addition, Intermountain is supporting communities and neighboring health systems with about 25 percent of patients transfers coming from other health systems in the intermountain west. The additional 75 percent of transfers come from Intermountain hospitals, InstaCares, and clinics.
Learn more about the Transfer Center or call 855-WE ADMIT (855-932-3648)