AAPS Main Site  |  Past & Future Meetings
American Association of Plastic Surgeons

Back to 2022 Abstracts


'Inappropriate' Emergency Transfers For Evaluation By Plastic Surgery
Joshua David, MD, Nerone O. Douglas, MSc, Phoebe L. Lee, BS, Elizabeth A. Moroni, MD, MHA, Devra Becker, MD, FACS.
University of Pittsburgh Medical Center, Department of Plastics Surgery, Pittsburgh, PA, USA.

PURPOSE: So-called 'inappropriate' patient transfers in plastic surgery (PRS) are common and costly, yet lacking in any operational definitions. To address this, we investigated emergent, interfacility transfer requests for plastic surgery consultation at our institution in order to identify potential barriers and solutions for reducing rates of 'inappropriate' transfers.
METHODS: We identified all transfer requests for PRS consultation at our institution over a one-year period and collected and analyzed relevant data.
RESULTS: We identified 287 transfer requests, of which 239 (83.3%) were accepted by PRS. Transfer acceptance was significantly associated with the time of day (p=0.034), but not patient age, sex, insurance status, distance, injury mechanism, or region. Nearly 90% of transfers arrived via ambulance despite a median distance of 30.4 miles (range 1-293). 10.0% of transfers were taken for emergent operative intervention, whereas 68.1% underwent ED procedure only. This constituted definitive treatment (i.e. no subsequent outpatient or inpatient interventions) in 60.8% of cases, with low rates of return to the ED (6.3%) or complications (4.2%). 19.2% of transfers were discharged without a hospital admission or any interventions. Patients not accepted by PRS for transfer did not experience delays in-clinic follow-up (1.85 vs 4.7 days, p=0.680) or scheduling outpatient procedures (0.7 vs. 3.95 days, p=0.698).
CONCLUSION: In this study, we utilize reproducible, objective, and evidence-based criteria to better characterize so-called 'inappropriate' patient transfer in PRS. Our findings represent a blueprint for identifying patients for whom emergent transfer for evaluation by a plastic surgeon may not increase the value of care.


Back to 2022 Abstracts


Miami
Miami
Miami
Miami