#110 A 5-year retrospective review of protocol 37 transfers from a model 3 hospital emergency department

<h3>Introduction</h3> Sligo University Hospital (SUH) is a model 3 hospital where emergency inter-hospital transfers are regularly required to access tertiary services. The transfer of patients from an Emergency Department (ED) is time sensitive, requires multi departmental input and carries inherent patient risk. There are no published studies looking at this process in Ireland. A five-year retrospective review of all patients transferred from SUH emergency department, using protocol 37 was performed. <h3>Methods</h3> A retrospective review was completed on all protocol 37 transfers from SUH emergency department from 01/06/2019 to 31/05/2024. We collected data including patient demographics, time and reason for attendance, reason for transfer, personnel involved in patient care, time taken to transfer and any delays to transfer. We analysed the data to identify any clear causation of delays to transfer. <h3>Results</h3> In total there were 402 patients transferred using protocol 37 over the five-year period. There were 270 (67%) males, the mean age was 56 years and there were 33 (8.2%) paediatric transfers. 139 patients (34.5%) self-presented to SUH ED and 298 (74.1%) were triage category 2. The most common reasons for transfer were MI 131 (32.5%) and stroke 63 (15.7%). The local tertiary referral centre received 211 (52.5%) patients. Over 25% of transfers required hospital medical staff to accompany them. The mean time from ED arrival to transfer was 5 hours 2 minutes. The mean time from protocol 37 activation to transfer was 1 hour 3 minutes. 41 (10.2%) had a documented delay to transfer. <h3>Conclusion</h3> This retrospective review shows the breath and complexity of patients transferred from a model 3 ED in Ireland. It is clear there are unnecessary delays to transfers and we aim to design and implement a transfer education programme and checklist to help improve efficiency and safety of the transfer process from an Irish ED.