Improving the Timeliness of Time-Critical Transfers: Removing ‘Referral and Acceptance’ from the Transfer Pathway

Where a ‘time-critical’ condition exists and care cannot be provided at the patient's current hospital, traditional ‘refer and accept’ pathways of care may delay immediate transfer. This paper describes how to identify time-critical patient groups and the sources of delay. This enabled a local clinical network to redesign the transfer process, resulting in the removal of specialist teams from the transfer decision-making process, changing the process from ‘refer and accept’ to ‘send and inform.’ In cases where referral to and acceptance by specialist teams were removed from the decision-making pathway, a median time saving of 1 hour 38 minutes was achieved.