Interhospital transfer of acute general surgical patients in the Taranaki region of New Zealand.

AIM: This study investigated the transfer of acute general surgical patients from HPH to TBH in order to evaluate Interhospital transfer time in a rural New Zealand setting. It specifically investigates the prioritisation and time to transfer of unwell patients who required ICU/HDU admission following transfer. METHOD: 9 months case-control retrospective study based on review of ambulance' "patient transfer sheets" and patients' medical records. Ambulance transfers of General Surgical emergencies were divided into two groups and analysed with group 1 admitted to ICU (ICU group) versus those admitted to the wards (non-ICU group). RESULTS: The majority of patients in the non-ICU group (34 patients, 77%) were managed conservatively while 8 patients (18%) underwent operative intervention. Four patients (24%) in the ICU group had surgery while 7 patients (41%) needed specialist investigations such as gastroscopy (n=5), ERCP (n=1) or angiography (n=1). One patient in each group died during their admission at TBH. CONCLUSIONS: There was no statistically significant difference in ambulance transfer times between the ICU and non-ICU groups (138 versus 124 minutes respectively), with the main determinant being the "ambulance response time" which could have been shortened by better identification of acute general surgical patients who ultimately required ICU/HDU care following transfer. The development of local protocols and checklists ensuring necessary communication between hospital and ambulance staff may allow better triage and prioritisation of transfer and lead to shorter transfer times for more unwell patients.