C22-12 What’s the Hold Up? Perceived Barriers to Timely Transfer From Emergency Department to the Intensive Care Unit

Abstract Rationale Delayed transfers from the Emergency Department (ED) to the Intensive Care Unit (ICU) have been associated with increased hospital length of stay, higher mortality rates and other adverse outcomes. This growing concern among both ICU and ED physicians suggests that delays in transfer have become increasingly common. The process of transferring patients from the ED to the ICU is multifaceted, with multiple factors potentially contributing to delays. This study aims to identify perceived barriers to timely transfers at an urban community teaching hospital through a multidisciplinary lens, providing insight into the factors affecting transfer efficiency and offering a foundation for targeted improvements. Methods We conducted a cross-sectional descriptive study at an urban community teaching hospital, surveying 94 healthcare providers (47 from the ED and 47 from the ICU). Participants included physicians (residents and attendings) and nurses (RNs), who anonymously completed surveys addressing 10 categories identified as critical to the transfer process, such as communication, available beds, and workup. The survey also allowed for open-ended responses to capture additional barriers not predefined in the categories. Results Both ED and ICU providers identified communication challenges (ED 57.4%, ICU 61.7%) and shift transitions (ED 63.8%, ICU 61.7%) as the most significant barriers to timely transfer. ED providers were more likely to cite ICU bed availability (40.4% vs. 14.9%, p = 0.0136), consultant recommendations (46.8% vs. 25.5%, p = 0.0056), and room or equipment setup (40.4% vs. 17.0%, p = 0.0010) as factors contributing to delays. In contrast, ICU providers were more likely to attribute delays to patient instability (40.4% vs. 12.8%, p = 0.0095). Notably, discrepancies were observed in the perceptions of what constitutes “instability” and the impact of ICU bed availability, highlighting differing experiences between departments. Conclusion Our multidisciplinary study underscores shared concerns regarding delays in ED-to-ICU transfers, particularly around communication and shift transitions. However, discrepancies regarding patient stability, room availability and the role of consultants point to divergent perspectives between the ED and ICU. These differences represent an opportunity to reconcile and align practices across departments, potentially improving transfer efficiency and reducing dwell time. By addressing these discrepancies, healthcare systems can enhance collaboration and communication, leading to more timely transfers and better patient outcomes. Further research is necessary to evaluate the impact of targeted interventions on the timeliness and quality of ICU transfers. This abstract is funded by: None