Introduction: Timely transfers from emergency departments (EDs) to specialized departments are crucial for ensuring prompt, appropriate care. Delays in these transfers can lead to adverse outcomes, extended hospital stays, and increased healthcare costs. This study aims to evaluate the causes and assess the impact of delayed patient transfers from the ED to specialized departments, to enhance patient care. The primary objective of the study is to record and categorize the root causes of the delayed transfer. Methods: After ethical clearance was obtained from the institutional ethical committee. This single-center, prospective observational study at AIIMS Bhopal included patients aged 18 years and above who remained in the ED for over 24 hours. Over six months, data were collected on delay factors such as patient-related issues (e.g., multiple comorbidities, poor prognosis), physician-related factors (e.g., inter-departmental communication gaps), and resource limitations (e.g., ICU bed availability). Descriptive statistics determined the prevalence of each delay factor, while Pearson’s Chi-square and Spearman’s rank correlation assessed associations between delay durations, patient outcomes, and APACHE II scores. Multiple regression analysis was adjusted for confounders to explore key factors influencing delays. Results: Delays were primarily attributed to inter-departmental confusion (40%), often in cases involving polytrauma, patients with multiple comorbidities, Additional factors included: lack of ICU bed availability (30%), patients managed completely outside the ED with no active interventions required from specialized departments (20%), and cancer patients with metastatic disease needing palliative care (20%). Miscellaneous reasons accounted for 10% of the delays. Transfer delays were associated with longer hospital stays but did not significantly impact overall mortality. Conclusion: Identifying and addressing factors that delay patient transfers can improve healthcare efficiency and patient outcomes. Streamlining communication and optimizing resource allocation can reduce Emergency Department (ED) overcrowding and ensure timely transfers to specialized care. Future efforts will focus on implementing these findings to minimize delays at our institution.
Lakra et al. (Sun,) studied this question.