Transferring patients to a pediatric trauma center: The transferring hospital's perspective

The rationale behind a regionalized trauma system is that patient outcomes are improved when trauma patients are rapidly transported to facilities wit h the level of expertise need to treat their injury. Functioning as an adul t Level II trauma center, we wanted to know how the transfer process worked for pediatric patients whom se transfer to a Level I pediatric trauma cent er, which is part of the same multihospital system, Complete information on time of arrival the time the transfer was accepted, and patient departure time were available for 116 patients (72% of pediatric patients transferred ) for the period of January 1, 1997 through June 30, 1998. Patients were re trospectively stratified into two priority groups representing differing tr ansport priority, based on use of a nasogastric tube, endotracheal tube or Foley catheter. Means for decision time and total time in transferring hosp ital were inspected, Decision time was 44 minutes (standard error 4.5 minut es) for priority patients and 92 minutes (11.5) for non-priority patients ( t = 2.94, df = 114, P = 0.004 Total time for priority patients was 129 minu tes (7.6) and 197 minutes (14.0) for non-priority patients (t = 3.37, df = 114, P = 0.001). Decision time was not influenced by extensive injury asses sment or secondary studies. On average, pediatric patients spent nearly thr ee hours in our facility. Our data indicate that a shorter decision time di d not necessarily result in a reduction in wait time. Improving pediatric t ransfer times requires attention not only to injury assessment processes at the transferring facility and interhospital communications but also mobili zation, hand-over, and any space or personnel constraints at the receiving pediatric facility.