3.Establish care protocols: "Even if you do know what the destination is, that doesn't necessarily mean you've had a conversation about what's the best care," Keroack said. Work with destination hospitals to develop specific care and transfer protocols for common conditions, such as stroke, sepsis, and trauma. Decide "what kinds of patients should be cared for at the university, what kinds of patients should be cared for at the community, what are reasonable treatments for these sorts of patients," Keroack said. "At least for the common case types it should be possible to have a sort of road map for how you're going to do things and at what point you're going to say: 'This is a patient who needs to travel.'"
4.Know when not to transfer: Having conversations about when to transfer may actually lead to fewer of them. If a patient has no hope of survival, she shouldn't be transferred far away from her family and familiar doctors and surroundings, Keroack said. In other cases, community hospitals may discover they're perfectly capable of dealing with certain patients themselves. "Many community hospitals are more able than they think they are to handle some of these cases, as long as they feel confident that whatever they're doing would be exactly what the destination hospital would do," Keroack said.
5.Start treatments at home: When patients have to travel long distances to an AMC, they lose valuable treatment time, Keroack said. One solution is to start treatment en-route. He points to the University of Kansas Medical Center, which was losing a lot of transfer patients to sepsis. "They were coming in pretty bad shape after traveling several hours," he said. "The folks at Kansas began a campaign to sort of coordinate the care of those patients so that once you recognize the diagnosis you would begin the first few steps of treatment out there in the field."