A letter to police station for transfer a patient from one hospital to another
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Inter-hospital and intra-hospital patient transfer: Recent concepts
Ashish Kulshrestha and Jasveer Singh
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Abstract
The intra- and inter-hospital patient transfer is an important aspect of patient care which is often undertaken to improve upon the existing management of the patient. It may involve transfer of patient within the same facility for any diagnostic procedure or transfer to another facility with more advanced care. The main aim in all such transfers is maintaining the continuity of medical care. As the transfer of sick patient may induce various physiological alterations which may adversely affect the prognosis of the patient, it should be initiated systematically and according to the evidence-based guidelines. The key elements of safe transfer involve decision to transfer and communication, pre-transfer stabilisation and preparation, choosing the appropriate mode of transfer, i.e., land transport or air transport, personnel accompanying the patient, equipment and monitoring required during the transfer, and finally, the documentation and handover of the patient at the receiving facility. These key elements should be followed in each transfer to prevent any adverse events which may severely affect the patient prognosis. The existing international guidelines are evidence based from various professional bodies in developed countries. However, in developing countries like India, with limited infrastructure, these guidelines can be modified accordingly. The most important aspect is implementation of these guidelines in Indian scenario with periodical quality assessments to improve the standard of care.
Keywords: Air transport, complications of patient transfer, intra-hospital, inter-hospital transfer, intra-hospital transfer guidelines, patient transfer
INTRODUCTION
The transfer of a patient to another facility or hospital or to another department in the same hospital is least known but an equally important topic. The decision to transfer the patient is based on the benefits of care available at another facility against the potential risks involved. The need to transfer a patient should take into account the benefit of providing extra care on the management or outcome. The risk of transferring a critically ill patient is manifold.[1] The various contributors of need to transfer the patient include the presence of few centres which provide super-speciality care, non-availability of speciality beds and funding of medical treatment.[2,3,4] Any intra- or inter-hospital patient transfer should aim at maintaining optimal health of the patient which is carried out by transferring the patient to the nearest facility providing highest specialised care.[5] Both the transferring and the receiving facility should aim at continuity of medical care of the patient. A poorly organised and hastily done patient transfer can significantly contribute to morbidity and mortality.[6] This article reviews the various guidelines for an effective intra- or inter-hospital transfer and current scenario of patient transfer in developing countries like India.
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