Patient Transfers to and from Critical Access Hospitals During the COVID-19 Pandemic


Rural hospitals, especially Critical Access Hospitals (CAHs), have long relied on transferring patients to other facilities for acute and specialized care. Since the onset of the COVID-19 pandemic, CAHs and non-CAHs alike have struggled to transfer some patients when needed due to limited ICU bed availability amidst case surges. The resulting delayed transfers can lead to increased patient safety risks and the use of valuable hospital resources. This brief describes both inbound and outbound transfer patient volumes among system-owned and independent CAHs and the barriers and facilitators to transferring patients that these CAHs have experienced during the COVID-19 pandemic. In this sample, a higher portion of system-owned CAHs reported a high volume of outbound transfers as well as moderate to high volumes of inbound transfers, compared to independent respondents. Participants noted a wide range of facilitators for transfers, but most commonly selected hospital relationships or care coordination as the biggest facilitator. Some promising transfer strategies during public health emergencies are discussed, including from previous literature and CAHs that participated in this survey. 


COVID-19 Health Systems Patient Safety Quality