Think before you act: A national survey of interhospital transfer policies and practices

Abstract

Introduction: As health care evolves, air medical program (AMP) interhospital transfers will come under increasing scrutiny. The object of this study was to evaluate various components of the interhospital transfer policies of AMPs across the country. Methods: A structured telephone interview of the chief flight nurse (CFN) or administrator of 90 geographically selected AMPs was conducted by a college-educated research assistant using a scripted questionnaire. Results: Seventy-seven (86%) of the AMPs contacted agreed to answer the questionnaire. CFN or administrator unavailability was the reason for nonresponse. The mean number of flights performed per year was 1046: 29% scene and 71% interhospital missions. Mission profile ranged from fixed-wing (19), rotor-wing (45), and both (13). Forty-five percent of respondents require prior administration approval and 31% require prior medical approval before accepting an interhospital mission. Financial approval or long distance transport was the most common reason for requiring approval. Ninety-four percent of programs transferred patients to facilities other than the AMPs' host hospital; two-thirds of these programs required medical (30%) or administrative (35%) authorization before accepting missions. Conclusion: This survey indicates that most AMPs use some form of screening mechanism for interhospital flight requests. With managed care requiring health care delivery systems to examine the use of resources, AMPs should continue to stay ahead of trends that affect the industry.