![]() A direct communication between the transferring and receiving facility should be undertaken with sharing of complete information on patient's clinical condition, treatment being given, reasons for transfer, mode of transfer and timeline of transfer, in a written document.Ī proper monitoring with the provision of all lifesaving drugs is mandatory for transfer of all patients with level 1, 2 and 3 critical care needs. These groups also arrange appropriate facilities at the receiving hospital or facility. In some countries, dedicated critical care transfer groups have been established to coordinate and facilitate the patient transfer. ![]() A written and informed consent of patient's relatives along with the reason to transfer is mandatory before the transfer. The decision to transfer the patient is taken by a senior consultant level doctor after thorough discussion with patient's relatives about the benefits and risks involved. The decision to transfer the patient is important because of exposure of the patient and the staff to additional risk and additional expense for the relatives and the hospital. 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. A poorly organised and hastily done patient transfer can significantly contribute to morbidity and mortality. Both the transferring and the receiving facility should aim at continuity of medical care of the patient. ![]() 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. 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. The risk of transferring a critically ill patient is manifold. The need to transfer a patient should take into account the benefit of providing extra care on the management or outcome. The decision to transfer the patient is based on the benefits of care available at another facility against the potential risks involved. 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 most important aspect is implementation of these guidelines in Indian scenario with periodical quality assessments to improve the standard of care. ![]() However, in developing countries like India, with limited infrastructure, these guidelines can be modified accordingly. The existing international guidelines are evidence based from various professional bodies in developed countries. These key elements should be followed in each transfer to prevent any adverse events which may severely affect the patient prognosis. 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. 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 main aim in all such transfers is maintaining the continuity of medical care. It may involve transfer of patient within the same facility for any diagnostic procedure or transfer to another facility with more advanced care. 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. ![]()
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