Intra- and interclinical patient transfer is an important aspect of patient care that is often performed to improve existing patient care. This may involve transferring a patient within the same facility for a diagnostic procedure or transferring the patient to another facility with more advanced care. The main objective of all these transfers is to maintain the continuity of medical care. Since the transfer of a sick patient can cause various physiological changes that can affect the patient`s prognosis, it should be initiated systematically and in accordance with evidence-based guidelines. Key elements of secure transfer include the decision on transfer and communication, stabilization and preparation prior to transfer, the choice of the appropriate type of transfer, i.e. ground or air transport, the personnel accompanying the patient, the equipment and follow-up required during the transfer and, finally, the documentation and delivery of the patient to the host institution. These key elements should be monitored in each transmission to avoid adverse events that can seriously affect the patient`s prognosis. The existing international guidelines are based on data from various professional associations in industrialized countries. However, in developing countries such as India with limited infrastructure, these guidelines can be amended accordingly. The most important aspect is the implementation of these guidelines in the Indian scenario with regular quality assessments to improve the standard of care.
All outpatient procedures for this patient would therefore be an O1 discharge status code and not an O2. And again, you have to be careful that this does not reflect the highest level of code for the discharge status code, because it is not always correct. And in a situation where the patient is transferred to an acute care department but is not admitted, the O2 is wrong. And you would have received a lower reimbursement based on the per diem rate compared to the full DRG. The transfer of care to patients can be defined as the movement of a patient from one flat surface to another. The most common patient transfers are from a bed to a stretcher and from a bed to a wheelchair. While seemingly intuitive, successful patient transfers depend on understanding each patient`s specific needs while adhering to evidence-based guidelines. Transfer of care to patients can also be defined as the transfer of patients within and between institutions. [1] [2] Mike: So Mary, let`s start the discussion by talking about the factors that influence how a hospital makes the decision to move a patient to another facility.
Once the patient is stable, you have the right to transfer that patient and consider the patient`s required care once they are stabilized. And if the additional treatment is not available in your facility, you can transfer that patient and make it an O2. But if the patient is not stable, of course you need to take care of him there. To move patients from a bed to a wheelchair, the patient`s needs must be understood. Always contact the person to be transferred so that support is provided in a timely manner so that efforts can be coordinated between the assistant and the patient. If the patient can carry weight on both lower limbs and take small predictable steps, assistance from one person can be performed. If these criteria are not met, a two-person transfer or a mechanical elevator may be required to transport the patient safely. If you are moving a patient from a bed to a wheelchair, first complete the pre-transfer checklist and proceed with the following steps: Air travel may not be feasible in environmental conditions that are dangerous to the aircraft, uncooperative patients, untreated pneumothorax or intrusive eye injuries, patients who have undergone recent abdominal surgery, potentially obstructed airways, shortness of breath, significant facial injuries and decreased consciousness. since these patients may experience sudden decompensation during air transfer. [23] Transfers are defined as the movement of a patient from one flat surface to another, for example, from .B bed to stretcher (Perry et al., 2014). Types of hospital transfers include stretcher bed, wheelchair bed, wheelchair to chair and wheelchair to toilet and vice versa. Patients with head injuries should have their Glasgow Coma Scale (GCS) adequately monitored and documented before and during transfer and prior to administration of a sedative or paralytic.
There are specific requirements that would allow a physician to charge for a discharge and an initial hospital code. The transfer cannot take place on the same day and the hospital file cannot be “merged”, which means that they are two separate institutions. This rule also applies to groups of physicians. Two doctors in the same practice are subject to the same restrictions. The patient should have at least two intravenous working cannulas with a wide bore in place before transfer. External bleeding, if any, should be adequately controlled and any shock should be treated with intravenous fluids and/or vasopressors. The availability of cross-blood may be required during transport. MICU: These are special vehicles with all the equipment and personnel for the transfer of critically ill patients and are usually used in cooperation with specialized recovery teams in a few industrialized countries. The literature also supports the use of UCUs with a reduced incidence of serious adverse events during transfer and improved survival rates with reduced mortality. [13,14,15] The transfer of a patient to another institution or hospital or to another department of the same hospital is the least known but equally important issue. The decision to relocate the patient is based on the benefit of providing care in another facility over the potential risks involved. The need to relocate a patient should take into account the benefit of additional care or outcome.
The risk of condemning a critically ill patient is manifold. [1] Among the various factors contributing to the need to transfer the patient are the presence of some centers that offer specialized care, the unavailability of special beds and the funding of medical treatments. [2,3,4] Any intra- or interclinical transfer of patients should be aimed at maintaining optimal patient health, which is achieved by transferring the patient to the nearest facility with the highest level of specialized care. [5] Transfer and reception facilities should aim for continuity of medical care for the patient. .