ArticleThe western journal of emergency medicine2020
Rural Interfacility Emergency Department Transfers: Framework and Qualitative Analysis.
Article in The western journal of emergency medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Emergency department crowding in the modern era: a systematic review (2018-2025).Clinical and experimental emergency medicine · 2026Pooled it
- Rural Emergency 360°: A mixed-methods analysis of barriers and priorities for equitable emergency care in Québec.PloS one · 2026Article
- A Validation Study of the Paediatric Non-Urgent Risk Assessment Management and Nurse Escort Assessment (PaNURAMA) Tool for Paediatric Inter-Hospital Transfers.Emergency medicine Australasia : EMA · 2025Article
- Experiences and Challenges of Rural Nurses in Botswana Handling Births Outside the Hospital Environment.Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing · 2025Review
- Interfacility Patient Transfers During COVID-19 Pandemic: Mixed-Methods Study.The western journal of emergency medicine · 2024Article
- Trends in Patient Transfers From Overall and Caseload-Strained US Hospitals During the COVID-19 Pandemic.JAMA network open · 2024Article
- The effect of telemental versus in-person mental health consults in the emergency department on 30-day utilization and processes of care.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2023Article
- Operation of national coordinating service for interhospital transfer from emergency departments: experience and implications from Korea.BMC emergency medicine · 2023Article
- Health-related reasons patients transfer from a clinic or health post to the Emergency Department in a District Hospital in Botswana.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2022Article
- Potentially avoidable interfacility transfers following reduced emergency department volumes due to COVID-19 "Safer-at-Home" orders.The American journal of emergency medicine · 2022Article
- Implementation of Telehealth for Psychiatric Care in VA Emergency Departments and Urgent Care Clinics.Telemedicine journal and e-health : the official journal of the American Telemedicine Association · 2022Article
- Transfer boarding delays care more in low-volume rural emergency departments: A cohort study.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2022Article
- Association of Rural and Critical Access Hospital Status With Patient Outcomes After Emergency Department Visits Among Medicare Beneficiaries.JAMA network open · 2021Article
- Association of insurance status with potentially avoidable transfers to an academic emergency department: A retrospective observational study.Journal of the American College of Emergency Physicians open · 2021Article
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Authors and funding
7 authors.
Funding
Abstract
introductionInterfacility transfers from rural emergency departments (EDs) are an important means of access to timely and specialized care.
methodsOur goal was to identify and explore facilitators and barriers in transfer processes and their implications for emergency rural care and access. Semi-structured interviews with ED staff at five rural and two urban Veterans Health Administration (VHA) hospitals were recorded, transcribed, coded, and analyzed using an iterative inductive-deductive approach to identify themes and construct a conceptual framework.
resultsFrom 81 interviews with clinical and administrative staff between March-June 2018, four themes in the interfacility transfer process emerged: 1) patient factors; 2) system resources; and 3) processes and communication for transfers, which culminate in 4) the location decision. Current and anticipated resource limitations were highly influential in transfer processes, which were described as burdensome and diverting resources from clinical care for emergency patients. Location decision was highly influenced by complexity of the transfer process, while perceived quality at the receiving location or patient preferences were not reported in interviews as being primary drivers of location decision. Transfers were described as burdensome for patients and their families. Finally, patients with mental health conditions epitomized challenges of emergency transfers.
conclusionInterfacility transfers from rural EDs are multifaceted, resource-driven processes that require complex coordination. Anticipated resource needs and the transfer process itself are important determinants in the location decision, while quality of care or patient preferences were not reported as key determinants by interviewees. These findings identify potential benefits from tracking transfer boarding as an operational measure, directed feedback regarding outcomes of transferred patients, and simplified transfer processes.
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