title: Effect of a centralised transfer service on characteristics of inter-hospital neonatal transfers.
abstract: OBJECTIVE
  To determine the effect of a centralised neonatal transfer service on numbers of neonatal transfers and the time taken for teams to reach the baby.
  
  
  METHODS
  Prospective census of neonatal inter-hospital transfers between May and July 2004. Comparison with a previous census undertaken before introduction of the service. Analysis of requests for antenatal in-utero transfer to the regional emergency bed service.
  
  
  METHODS
  Geographically defined area in London and southeast England.
  
  
  METHODS
  Babies transferred to or from a neonatal unit.
  
  
  METHODS
  Introduction of a centralised neonatal transfer service.
  
  
  METHODS
  Numbers of transfers, time taken for teams to arrive to the baby (response time).
  
  
  RESULTS
  During the census there were 835 transfers with an increase of 34% from the previous census (n = 619). Most of the increase was in urgent transfers for neonatal intensive care. There was a mean of 4.4 urgent transfers a day, with 3.9 elective and 0.8 short-term transfers. Over the same period in-utero transfers decreased. Response times improved from a median of 2 h in 2001 to 1.45 h in 2004 (p<0.05). The 90th centile fell from 6 h to 4.9 h.
  
  
  CONCLUSIONS
  Following the introduction of a centralised neonatal transfer service, response times improved significantly. An increase in the numbers of transfers for medical intensive care was associated with a reduced number of in-utero transfers. To balance the improved safety and accessibility of neonatal transfer, similar developments may be needed to facilitate in-utero transfer.
authors.affiliation: Barts and the London, NHS Trust, London, UK. steve.kempley@bartsandthelondon.nhs.uk
authors.forename: S T
authors.initials: ST
authors.lastname: Kempley
authors.forename: Y
authors.initials: Y
authors.lastname: Baki
authors.forename: G
authors.initials: G
authors.lastname: Hayter
authors.forename: N
authors.initials: N
authors.lastname: Ratnavel
authors.forename: E
authors.initials: E
authors.lastname: Cavazzoni
authors.forename: T
authors.initials: T
authors.lastname: Reyes
mesh_terms: D004739:England; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal / Q000458:organization & administration / Q000706:statistics & numerical data*; D010360:Patient Transfer / Q000458:organization & administration / Q000706:statistics & numerical data*; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data; D011446:Prospective Studies; D013997:Time Factors; D014187:Transportation of Patients / Q000458:organization & administration / Q000706:statistics & numerical data