ANGIE FRANKS details how a cumbersome transfer process can lead to physician burnout and how an efficient one can lead to physician retention and better patient outcomes.
Emergency doctors are likely familiar with this scenario: A patient comes to the emergency department, and an examination and diagnostic tests reveal the patient needs a surgical intervention, which requires a transfer to another facility.
What happens next?
An emergency doctor starts calling various hospitals hoping someone there can reach a physician to consult with them and initiate a transfer. Calls are made and messages are left. Meanwhile, physicians –and especially patients – are left frustrated and worried as the patient’s condition is at risk.
If a hospital had a nickel for every time this scenario played out, it would cover the cost of readmissions penalties. It’s time hospitals took a hard look at the burnout patient transfers cause not only to physicians and nurses – but, most importantly, the risk to the patient.
Unsuccessful or delayed transfers mean the patient isn’t receiving the appropriate care at the right time and the right place, raising safety and outcome concerns. A poorly run transfer center can tax clinicians, but a well-run one makes their jobs easier and allows clinicians to feel confident in delivering the right care to their patients without delay.
Creating the kind of transfer center that reduces burnout, and improves clinician and patient experiences often requires operational and technological changes. However, health systems that have undergone this transition are experiencing improved volume growth and reduced network leakage – not to mention the fact that research has found their staff are saving countless hours every month due to improved efficiency and fewer administrative burdens.
Emergency physicians most burned out
The frustration of transferring patients to the right care venue without delay is one of the many contributors to the burnout of emergency physicians, which is the specialty that ranked the highest in burnout among 27 surveyed, according to recently released Medscape study. Nearly 60 per cent of emergency physicians reported feeling burned out in 2017, up from half in 2013.
Patient transfers, while a small part of a provider’s job, could be considered among the “too many bureaucratic tasks” and “spending too many hours at work” complaints that were cited as the top causes of burnout in the survey results. An efficient, provider-friendly patient transfer center can address both these top causes of burnout and many others.
For example, consider an emergency physician in a community-based rural hospital. Imagine that physician’s relief after having their patient transferred quickly and efficiently – typically with a one-call system where an accepting physician comes on the line to discuss the patient and then directly admits that patient to the right care setting, bypassing the ED. This makes the referring doctor’s life easier and saves time and aggravation – while getting the patient the care needed without delay.
Now imagine the physician on the other end of the phone with the transferring patient’s relevant clinical transfer information available, and the ability to track the patient transport in real time so the treatment/care team can be prepared upon the patient’s arrival. The stress level for all stakeholders has decreased, including the patient and his/her family, who aren’t waiting and wondering if their loved one will receive the critical care that’s needed.
Streamlining transfer center operations
The first step in reducing transfer-related burnout is assessing current transfer center operations and volume. Included in this assessment should be a determination of the number of phone calls it typically requires for a referring physician who has an emergent patient under his/her care to transfer to your health system. If it’s more than one call, or it requires many voicemails or waiting for on-call physicians to respond, then the referrer may look elsewhere for their patient’s care. That’s why having a single phone number for the entire health system is so crucial. One phone number to remember and only one call to arrange a patient transfer, day or night, can immediately move a health system to top of mind for any referring physician.
Secondly, that single phone call must ensure a positive experience, which means health systems should staff their transfer center with qualified and experienced clinicians who can offer relevant clinical insight about the facilities available at their organization and collaborate with the providers involved about the ideal care venue. That transfer center staff member should have well designed workflows and protocols available, clear visibility to facility resources, and a comprehensive overview of physician schedules so they can let the referrer know who’s available and facilitate a phone consult between the physicians.
Such technology should also deliver analytics that allow the transfer center to easily identify opportunities for improvement, so the department becomes even more efficient and more of a pleasure to use for referring providers.
Reducing burnout one cause at a time
Establishing a well-run, centralized transfer center won’t eliminate clinician burnout by itself, but it can reduce the multiple phone calls, missed voicemails and frustrations that contribute to burnout and suboptimal patient care. An efficient, service-oriented, transfer center can also contribute to a culture that strives to improve the clinician experience by removing unnecessary obstacles between them and optimal patient care delivery.
- Angie Franks is CEO and president of Central Logic.