title: Interhospital transfer of acute general surgical patients in the Taranaki region of New Zealand.
abstract: OBJECTIVE
  This study investigated the transfer of acute general surgical patients from HPH to TBH in order to evaluate Interhospital transfer time in a rural New Zealand setting. It specifically investigates the prioritisation and time to transfer of unwell patients who required ICU/HDU admission following transfer.
  
  
  METHODS
  9 months case-control retrospective study based on review of ambulance' "patient transfer sheets" and patients' medical records. Ambulance transfers of General Surgical emergencies were divided into two groups and analysed with group 1 admitted to ICU (ICU group) versus those admitted to the wards (non-ICU group).
  
  
  RESULTS
  The majority of patients in the non-ICU group (34 patients, 77%) were managed conservatively while 8 patients (18%) underwent operative intervention. Four patients (24%) in the ICU group had surgery while 7 patients (41%) needed specialist investigations such as gastroscopy (n=5), ERCP (n=1) or angiography (n=1). One patient in each group died during their admission at TBH.
  
  
  CONCLUSIONS
  There was no statistically significant difference in ambulance transfer times between the ICU and non-ICU groups (138 versus 124 minutes respectively), with the main determinant being the "ambulance response time" which could have been shortened by better identification of acute general surgical patients who ultimately required ICU/HDU care following transfer. The development of local protocols and checklists ensuring necessary communication between hospital and ambulance staff may allow better triage and prioritisation of transfer and lead to shorter transfer times for more unwell patients.
authors.affiliation: Department of General Surgery, Auckland City Hospital, Private Bag 92024, Victoria St West, Auckland 1142, New Zealand. dramirbutt@hotmail.com.
authors.forename: Amir
authors.initials: A
authors.lastname: Butt
authors.forename: Primal P
authors.initials: PP
authors.lastname: Singh
authors.forename: Glenn
authors.initials: G
authors.lastname: Farrant
authors.forename: Stephen
authors.initials: S
authors.lastname: Kyle
authors.forename: William
authors.initials: W
authors.lastname: Gilkison
authors.forename: Michael
authors.initials: M
authors.lastname: Fancourt
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Hill
authors.forename: Damien
authors.initials: D
authors.lastname: Mosquera
mesh_terms: D000293:Adolescent; D000368:Aged; D000369:Aged, 80 and over; D000552:Ambulances; D002648:Child; D002675:Child, Preschool; D005260:Female; D013502:General Surgery / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D010360:Patient Transfer / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult