Patient Transfer Process From Pre-Hospital to the Hospital Emergency Department: A Grounded Theory Study.
Maryam Jamsahar, Fazlollah Ahmadi, Mitra Khoobi and 1 others
PMID 40607736WHAT IT FOUND
Emergency staff described pre-hospital to hospital transfer as dominated by anxious relatives' pressure, insults and threats.
They managed this by persuading, staying silent, speeding transfer or handing responsibility over, sometimes against clinical judgement.
Key findings
01Emergency care providers identified the delay in safe transfer and threat to patient survival as the main concern, with relatives' distress, pressure, insults, threats and violence as key features.
02The central strategy was diligent avoidance of tense confrontation, using situational resourcefulness, persuasive communication and forbearance.
03Outcomes ranged from successful persuasion to failed persuasion, escaping responsibility, long-lasting hidden tension and surrendering.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study describes experiences and perceptions, not measured patient outcomes, so it cannot show that any strategy made transfer safer. Participants were selected purposively and theoretically in seven Iranian cities, so findings may not apply to other emergency systems. The authors could observe and document hospital emergency handover more easily than pre-hospital work, so some pre-hospital processes were less directly observed. Early interviews were conducted online because of the COVID-19 epidemic, while later interviews were face-to-face. Only 2 patients and 4 relatives were included, so family perspectives are limited.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not read the strategies as tested treatments that improve patient transfer. The study reports what providers experienced and did, including expedient lies and pressured transfers, and does not show that these actions made patients safer.