title: The impact of an independent transfer center on the evaluation and transport of patients with burn and maxillofacial injuries to definitive care at a level 1 trauma center.
abstract: OBJECTIVE
  To assess the impact of an independent call center on facilitation of burn and maxillofacial trauma patient transfer to a level 1 trauma center.
  
  
  METHODS
  All patients admitted to our level 1 trauma center for definitive management of either burn or maxillofacial injuries from September 1, 2004 to September 1, 2008, 2 years before and after transfer service initiation on September 1, 2006, were identified using the North Carolina Trauma Registry. Cohort demographics, referral patterns, transfer times/distances, and clinical outcomes were assessed.
  
  
  RESULTS
  Burn patients increased from 1031 to 1208, from the 2 years before to after transfer center initiation. Average transport time increased from 113 to 165 minutes and average distance traveled increased from 84 to 86 miles. Out-of-state admissions increased from 24 to 46; number of referring counties increased from 58 to 60. Maxillofacial trauma patients increased from 390 to 576. Average transport time increased from 87 to 119 minutes, average distance increased from 84 to 89 miles, and number of referring counties jumped from 28 to 43. Length of stay did not change over the study period.
  
  
  CONCLUSIONS
  The initiation of an independent call center, designed to facilitate the transfer of patients with burn and maxillofacial injuries to a level 1 trauma center, increased the number of referrals and expanded our geographic footprint, but did not decrease transport times.
authors.affiliation: Division of Plastic Surgery, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Surrusco
authors.forename: Winnie
authors.initials: W
authors.lastname: Tong
authors.forename: Katherine S
authors.initials: KS
authors.lastname: Roden
authors.forename: Preston B
authors.initials: PB
authors.lastname: Rich
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Cairns
authors.forename: William W
authors.initials: WW
authors.lastname: Shockley
authors.forename: C Scott
authors.initials: CS
authors.lastname: Hultman
mesh_terms: D002056:Burns / Q000628:therapy*; D015331:Cohort Studies; D004631:Emergency Medical Service Communication Systems; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008446:Maxillofacial Injuries / Q000628:therapy*; D009657:North Carolina; D010043:Outcome and Process Assessment, Health Care; D010343:Patient Admission / Q000706:statistics & numerical data; D010360:Patient Transfer / Q000458:organization & administration*; D012017:Referral and Consultation / Q000458:organization & administration / Q000706:statistics & numerical data; D012042:Registries; D012189:Retrospective Studies; D014187:Transportation of Patients / Q000706:statistics & numerical data; D014193:Trauma Centers