Transfer Center Guide

 

Schedule:

-day team person takes the calls from 8 am to 7pm M-F.

-On call attending takes calls when ortho person is not

 

Taking a call:

-Response time should be within 10 minutes but if you are in the middle of something it is usually OK to call and say you will deal with this a bit later.

-Ask if this is a EMTAlA call

-Transfer center operators will connect you with transferring physician.

-After talking with the physician you decide to accept the transfer or not.

-You can also work out redirecting the transfer to a different service if this is appropriate.

 

Who to take: (these are guidelines only take whomever you want!)

-Patient requires a procedure or service that cannot be obtained at their current institution

-Patient requires expertise not available at current institution

-Patient is normally a Stanford patient and would benefit from continuity of care

 

Maybe accept these patients:

-Physicians requesting a second opinion for complex disease process, ie “we don’t know what to do”

-Family request to have patient at Stanford

-Kaiser wants the patient out of their hospital

 

Please do not accept:

-Patient is unstable for transfer

-Patient requires a level of care not provided outside of the ICU

-Transfer request is because of “challenging family” or “difficulty of placement”

-Stanford would not do anything different and there is not compelling reasons to transfer care.

 

EMTALA:

-Law designed to protect patients and assure them emergency care in life threatening situations.

-Can only be invoked when a patient is treated in an emergency department

-Our transfer center is not allowed to ask about financial eligibility

-It is the ED physician who establishes if the situation is life threatening not you

-Your role is to figure out if you believe the patient is stable for transfer and for a non-ICU bed and accept.

 

Great now you have accepted a transfer:

Once you have accepted a patient it may be days before a bed is available so it is common that you do not know when a patient will actually arrive.

Ask the transfer center to page you when they have an ETA.

If they believe it will happen overnight notify the person taking transfer calls overnight.

Once an ETA is established you can sign out the patient to the admitting resident with instructions to pass on the information if they cap

 

A word on conflicts:

-At time OSH docs can become unprofessional when you deny their request. Maintain professional behavior and remember the calls are being recorded.

-Always have OSH docs call you through the transfer center and not on your cell phone or pager

-If you believe a transfer patient is better served by a different service it is reasonable to contact them yourself or have the transfer center take care of this.