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ICU to ICU transfers: what is your policy?

Caesar Ursic cmursic at gmail.com
Sun Apr 1 19:30:26 BST 2012


Thanks for all of the comments.

I am *not* referring to transfer to a lower level of care in the sense that
a patient is in ICU and you want to transfer to floor bed somewhere else.
Rather, I am referring to an *ICU to ICU transfer*, when the sending ICU is
in a trauma center and the receiving ICU is in a non- trauma center.

How do you all feel about that?

Personally, I think those types of transfers should be very seldom and
rare, and certainly not based on economics.




On Sun, Apr 1, 2012 at 6:44 AM, Gross, Ronald <
Ronald.Gross at baystatehealth.org> wrote:

> Caesar,
> In fact there is - and it is written as such in part because the COT and,
> more importantly (if you can imagine that) insurers mandate it.
> Ron
>
> Sent from my iPhone
>
> On Mar 31, 2012, at 6:00 PM, "Caesar Ursic" <cmursic at gmail.com> wrote:
>
>  > 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-dogs-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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> >
> >
> >
> > --
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> > Did gyre and gimble in the wabe:
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> > And the mome raths outgrabe.
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-- 
'Twas brillig, and the slithy toves
Did gyre and gimble in the wabe:
All mimsy were the borogoves,
And the mome raths outgrabe.


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