Abstract
BACKGROUND: While interhospital patient transfers are common, most existing literature centers on transfers to academic medical centers (AMCs) and tertiary/quaternary care hospitals for a higher level of care. With the growing trend of healthcare system consolidation and formation of regional affiliations, many systems now coordinate admissions and capacity on a broader system-wide scale. As a result, some AMCs have developed programs to facilitate outbound transfer to regional affiliate hospitals. This shift prompted our study. OBJECTIVES: Our study aims to understand the current landscape of outbound transfer programs and to identify key facilitators and barriers to successful implementation, resultant operational successes, and future aspirations. METHODS: We conducted semi-structured qualitative interviews with AMCs across the United States that have an affiliation with another institution. Affiliation is defined as "an agreement to collaborate on an initiative or to provide a specific service together. This may involve local, regional or national partners." Data were analyzed using inductive and deductive methods in Nvivo software. RESULTS: We conducted interviews with 12 AMCs from all four major United States regions ranging from 550 to 1700 beds. We identified five key themes from the study and included: (1) transfer activity, (2) barriers to implementation, (3) facilitators to implementation, (4) successes, and (5) aspirations. CONCLUSION: This study highlights the vital role of patient transfer programs in ensuring high-quality care and managing capacity within AMCs and healthcare systems. Successful implementation depends on addressing inefficiencies, fostering collaboration, and promoting equitable care. Prioritizing these factors can improve patient outcomes and alleviate capacity constraints, enabling timely access to necessary care.