Interhospital transfers for emergency general surgery (EGS) conditions have increased in recent years in the United States (US). Older patients with EGS diagnoses are more likely to be transferred between hospitals and experience worse outcomes than younger patients. A contributing factor to these worse outcomes is that care coordination suffers during interhospital transfers. Provider communication is particularly critical to decisions about transfers of older adults due to circumstances that are unique to their care. Comorbid conditions and acute illness can limit older adults’ cognitive capacity to provide their health history and fully participate in medical decision-making, including transfer decisions. Interhospital transfers also fragment care and separate older adults from their regular healthcare providers and, sometimes, their family support and surrogate decision makers, who often advocate for their needs and medical decision-making.
The Supporting Interhospital Transfer Decisions (SITe) Toolkit was specifically designed to assist accepting providers during the third conversation of the transfer call. The tools are a script and checklist to help accepting providers guide the conversation with the referring provider. Accepting providers were selected as the target user because they lead the 3-way conversation and know what information they need to make a decision about transfer. In addition to the tools, the SITe Toolkit contains resources to train accepting providers and to increase awareness of use of the tools among other parties involved in interhospital transfers.
View the Toolkit