Learning from critical care: Improving intra- and inter-hospital transfer processes in enhanced care and the ward.

The Intensive Care Society (ICS) has recently published guidance on the transfer of critically ill adults. Since 2007, the North West London Critical Care Network has documented and audited patient transfers undertaken across 13 hospitals, and trained staff in transferring critically ill or injured patients. In 2015/16 the network introduced intra-hospital transfer documentation and applied the same transfer training and audit methodology for critically ill patients being moved within hospitals. While increasing data capture and with a targeted training strategy adapted from transfer experience, the network has seen a reduction in number and severity of incidents in the region. In contrast to this experience, no formalised processes exists to support the inter-hospital or intra-hospital transfer of patients from enhanced care areas or wards not embedded within critical care. Often very little data is collected from these areas, but we suspect transfer risks are higher in these cases as a consequence of the deficit of structured transfers. In collaboration with members of the critical care network, we have developed a basic training module along with the use of a transfer form which has been well received and had a positive impact in terms of incidents reported.