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ICU to ICU transfers: what is your policy?

McSwain, Norman E nmcswai at tulane.edu
Sun Apr 1 00:07:51 BST 2012


CMS and EMTALA have rules that you cannot transfer to a lesser level of
care

Norman

Norman McSwain MD, FACS
Professor of Surgery, Tulane University
Trauma director, Spirit of Charity Trauma Center, ILH
504 988 5111


-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of Caesar Ursic
Sent: Saturday, March 31, 2012 5:00 PM
To: Trauma-List [TRAUMA.ORG]
Subject: Re: ICU to ICU transfers: what is your policy?

Ron, at your hospital is there any sort of policy, either informal or
written, that states that you do not transfer your ICU patients out to
lesser level of care ICU (i.e. to an outside non trauma center ICU)?



On Sun, Apr 1, 2012 at 9:05 AM, Robert Smith <rfsmithmd at comcast.net>
wrote:

> Ron,
>
> The bottom line is the podcast.
>
> You sound totally exhausted. I've heard trauma is a young man's game. 
> Is there any truth to that?
>
>
>
> Thanks for thinking of us,
>
> Rob
>
>
>
> Robert Smith, MD, MPH
> Secretary War Dogs Making It HomeChair, Div Pre-hospital Care and 
> Prevention (ret) Department of Trauma John H.Stroger Jr. Hospital of 
> Cook County War Dogs - Making it home Tiny service dog heals Hampshire

> Marine - DailyHerald.com
>
> http://www.whereistheoutrage.net/wordpress/2012/03/20/interview-war-do
> gs-making-it-home
>
>
>
>
>
>
> On Mar 31, 2012, at 11:44 AM, Gross, Ronald wrote:
>
> > You cannot justify transferring a patient from a higher level of 
> > care to
> a lesser level of care. You just can't.  On the other hand if the 
> patient is on the floor and the level of care is basic then I could 
> see the convenience transfer.....sometimes.
> > Ron
> >
> > Sent from my iPhone
> >
> > On Mar 31, 2012, at 11:12 AM, "Caesar Ursic" <cmursic at gmail.com>
wrote:
> >
> >> For those of you who work in designated/verified trauma centers:
> >>
> >> What is your official policy (or your opinion if there is no actual
> policy
> >> where you are) on the transfer of trauma patients from *your* ICU 
> >> (at a trauma center) to another ICU at an outside hospital that is 
> >> *not* a
> trauma
> >> center?  Obviously I am speaking of transfers for reasons *other* 
> >> than provision of higher level of care, i.e. you are transferring 
> >> for non-medical reasons.  Perhaps the reason is that the family 
> >> wants the patient to be closer to home, or perhaps the patient 
> >> belongs to a
> hospital
> >> plan that, for financial reasons, prefers its patients to be 
> >> treated at specific participating institutions which are NOT 
> >> designated trauma
> centers.
> >>
> >> Is it an acceptable risk to the patient to transfer him/her ICU to 
> >> ICU
> when
> >> there is no *medical* need to do so? Or should the transfer wait 
> >> until
> the
> >> patient is downgraded to "floor status," based on improvement of 
> >> medical condition and acuity?
> >>
> >> Many thanks,
> >>
> >> C. Ursic, MD
> >> --
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