Operation of a Transfer Center: Clinical vs. Non-Clinical Staff

There appears to be some debate over whether to use clinical staff (RNs) or non-clinical staff when operating a Transfer Center. However, there is a growing trend to use clinical staff in Transfer Centers rather than non-clinical as a best practice for several reasons. But before I discuss the rationale of using clinical staff, the Transfer Center Director must first understand their hospital’s primary reasons and objectives for establishing a Transfer Center.

The primary consideration of whether you use clinical or non-clinical staff (or combination) should be the transfer process you choose to implement. Are you solely working with transfer/transport requests or are there other calls handled, such as consults with physicians or other referring/access type calls? Is your process to immediately connect your on-call physician with the referring/transferring physician? Do you take demographics and baseline clinical information upfront first and disconnect from the initial call, to call them back within an established time frame? Does the Transfer Center staff work with (or is it part of) another department or call center-type group? Does the Transfer Center also have roles and responsibilities in Patient Placement (Bed Control)?

There is a growing trend across the country to have clinical staff in a Transfer Center. Reasons to use clinical staff are as follows:

1. They have better understanding of the conversation occurring between physicians about the patient and clinical situation.
2. Clinical staff is better positioned to discuss levels of care needed for the patient and/or to obtain additional information for the accepting physician to make a more informed decision for optimal patient safety.
3. Clinical staff can be educated on InterQual and other screening materials and activities to support Case Management and Hospital Finance.

There are some Transfer Centers that use non-clinical staff on transfer calls. While this may work for them and support their unique goals, objectives and competitive strategies, they will balance that with clinical staff in patient placement. Additionally, the trend seems to be that many new Transfer Centers are being developed as an extensions of Patient Placement departments. Without optimal patient flow and bed management communications, a Transfer Center’s focus of increasing admissions (and improving hospital financials) cannot happen! It makes sense–and becomes best practice–to have these two functions work very closely together.