Monday, January 6, 2020

Interfacility Transfers

emDocs - January 06, 2020 - By Durrani O; Ely R and Kester N
 Reviewed by: Simon E, Koyfman A and Long B
"Take Home Points
  • Emergency medicine transfers are conducted on principles outlined in the 1986 Emergency Medical Treatment and Labor Act, or EMTALA4.
  • Patients must be stabilized to the best of the facility’s ability prior to transfer. Any life-threatening process that requires immediate management must be treated prior to transfer.
  • If specialty consultation is required, it is important that as the ED physician accepting a transfer, you ensure the specialist has agreed to accept and see the patient.
  • As a receiving physician, you have an obligation to report inappropriate transfers (EMTALA violations) within 72 hours8 – not doing may result in facility termination of Medicare participation9.
  • A common pitfall for ED physicians is to perform an extensive evaluation on a trauma patient that requires transfer. Recognize the resource limitations of your facility early. Avoid workups that won’t change patient management17.
  • Frequently, patients are transferred long distances, which may make discharge difficult if there is limited social support. Engage case workers and discharge planners to address these unique situations."