Slow hospital transfers are costing lives in Illinois, study finds

Trauma surgeon Anne Stey is haunted by the lives she couldn’t save.

While she was working a shift at a San Francisco hospital, a patient came in with a life-threatening heart emergency. The patient’s aorta had a hole. Without immediate care, they would bleed to death.

Her hospital could handle serious traumas like a gunshot wound or a car crash. But it didn’t have a heart surgeon or tools for a heart operation.

Stey and her colleagues spent hours keeping the patient stable and frantically calling nearby hospitals to see who could take them. Finally, a colleague contacted a heart surgeon at Stanford who eventually repaired the aorta.

“It becomes a frantic dig through everyone’s Rolodex: ‘Who do you know at this hospital?’ And there has to be a better way,” Stey said. She has worked in emergency rooms in New York, California, and is now a trauma and critical care surgeon at Northwestern Memorial Hospital.

Stey wants to make transferring patients between hospitals simpler and faster, a fix she says will prevent deaths. She recently published research that found people in Illinois are dying while waiting to be transferred to trauma centers.

Her research found that up to 34% of critically injured patients showed up at a hospital not equipped to treat them and faced life-threatening delays while awaiting transfer to a trauma center.

A potentially deadly delay

A smoother transfer process could have saved Yvonne Mosley’s life, an attorney representing her family told the Sun-Times.

In late October 2022, Mosley, 77, was taken to Little Company of Mary on the Far South Side. She had been dealing with significant health issues, including dementia, hypertension, and diabetes. She spent the next two weeks in the hospital, said Shawn Barrett, Mosley’s family lawyer.

On Nov. 5, she woke up with a facial droop and struggled to communicate. She was moved to the intensive care unit, but doctors soon determined she needed advanced care they couldn’t provide.

They arranged an emergency transfer to Advocate Christ Medical Center two miles away. But it took five hours to move her.

Once she arrived at Christ that evening, a scan revealed a bleed in her brain. She underwent emergency surgery but never woke up. She died on Nov. 9.

“It’s inexcusable,” Barrett said. “Once they realized they couldn’t help her, that they knew she needed immediate care, why did it take five hours to transfer her?”

Barrett filed a lawsuit against Little Company of Mary on behalf of Mosley’s family. The hospital declined to comment on ongoing litigation.

‘No global understanding’

A patient might be transferred to another hospital for several reasons. Sometimes the hospital can’t treat a patient’s injury or health emergency. Other times, the hospital is overwhelmed and doesn’t have space or staff to care for them.

“This begins an arduous and stressful process, as the hospital tries to find a bed for a patient whose life is hanging in the balance,” Stey said.

Individual medical centers often operate as one big system given that patients tend to move between hospitals and clinics, she said.

“But there is no global understanding of what happens across that entire system,” Stey said. “There’s not a clear understanding between hospitals, and no one has been tasked with being responsible for managing these transfers.”

So it falls on the clinical teams taking care of patients, she said.

One care team Stey and her colleagues surveyed said they spent an entire eight-hour shift to get just one person from their ER to a suitable hospital.

“To spend an entire shift on one person is unsustainable,” she said. “What about everyone else they need to see and attend to?”

Simple solutions

To improve patient transfers, Stey suggests Chicago and Illinois create a real-time hospital bed tracker, a system popularized during the COVID-19 pandemic.

The tracker would provide hospitals across the city and state real-time data on how many beds hospitals have and whether enough staff is available to treat an incoming patient.

“If they know the number of beds at other hospitals, the sending hospital can find a bed much faster,” Stey said.

Before the pandemic, the Chicago Department of Public Health developed a bed tracker as a part of an overall hospital preparedness program, Stey said. In case of a mass casualty event, for example, the bed counter would be used to determine which hospitals could manage a lot of patients at once and which ones couldn’t.

But during COVID-19, many hospitals didn’t rely on the data in the health department’s tracker because it was only updated once a day at 10 a.m., Stey said.

“Ten a.m. in an ER can be very different from 10 p.m. So they wouldn’t check it. It wasn’t reliable,” she said.

The city health department has been in “regular dialogue” with Stey about her work and ways to “improve Chicago’s hospital bed availability data,” a spokesperson told the Sun-Times.

But the city did not say whether the department is considering creating a transfer program. The department deferred to the Illinois Department of Public Health on any statewide efforts for a patient transfer center.

The state health department did not respond to requests for comment about whether a real-time bed tracker and transfer operation was possible.

Conclusion

The study’s findings are alarming, and it’s essential to address the issue of slow hospital transfers. By creating a real-time hospital bed tracker and simplifying the transfer process, we can save lives. As Dr. Stey said, “There has to be a better way.”

FAQs

* What is the current process for transferring patients between hospitals?
The current process is often manual and relies on phone calls and faxes, which can lead to delays and errors.
* How can we improve the current process?
One solution is to create a real-time hospital bed tracker, which would provide hospitals with real-time data on available beds and staff. This would help streamline the transfer process and reduce delays.
* What are the consequences of slow hospital transfers?
Slow hospital transfers can lead to delayed treatment, increased mortality rates, and increased healthcare costs. It’s essential to address this issue to save lives and improve patient outcomes.
* What is being done to address the issue?
The Chicago Department of Public Health has developed a bed tracker as part of its hospital preparedness program. However, the tracker is not updated in real-time, and hospitals don’t rely on it. The Illinois Department of Public Health has not responded to requests for comment on whether they are considering a real-time bed tracker and transfer operation.