An Observational Study of the Factors Affecting Staffing Demands During Intrahospital Transfers

ObjectivesThis study quantified the total time required by staff to complete intrahospital transfers (IHTs) and identified key activities and facility attributes affecting efficiency.BackgroundIHTs, which involve moving patients between rooms or units, place significant demands on healthcare staff and facility resources. While previous studies have explored the impact of IHTs on patient safety and clinical efficiency, few have assessed the specific tasks and time demands on all staff members involved.MethodsFifty IHTs (39 between-unit, 11 within-unit) were observed at a 718-bed level-1 trauma hospital. Transfer tasks were categorized into 13 activity types. These included managing equipment, belongings, and supplies (EBS), handoff communication, and patient transport.ResultsIHTs required a mean of 77 min of staff time, 53 min (75%) of which was nursing time. EBS management accounted for the largest share of transfer time, followed by handoff communication. Transfers with an increase in acuity level required more staff and additional total time. Elevator use was associated with a significant increase in nursing time. Issues that added to transfer time included miscommunication about room readiness and the need to acquire or transport specialized equipment.ConclusionsStreamlining EBS processes, optimizing staffing for acuity-related transfers, and improving elevator availability could reduce IHT times and alleviate workload on nurses. Enhanced coordination during shift changes, better communication about room readiness, and support for non-clinical tasks offer further opportunities to improve efficiency. These findings underscore the role of facility design and operations management in enhancing hospital efficiency, reducing nursing burden, and improving patient care.