Abstract DP157: Improving Stroke Transfers Through Structured Feedback: A Multisite Interfacility Model

Background and Issues: Inefficiencies in communication and feedback during interfacility stroke transfers contribute to delays, inconsistent care, and disrupted continuity. Referring teams lacked standardized mechanisms to share feedback, limiting opportunities to optimize imaging, coordination, and timely intervention. At UCSF Health, baseline feedback rates were below 35%, and door-to-device times exceeded national benchmarks. Nationally, these transfer gaps are known to negatively affect time-sensitive stroke care and equitable access to treatment. Purpose: This quality improvement project aimed to implement a structured interfacility transfer feedback model to improve communication, reduce response times, and enhance care continuity for stroke patients. Methods: This quality improvement project was conducted between January and June 2025 and included over 100 stroke transfer cases across UCSF Health and partner facilities. The project aimed to reduce response times, improve communication, and enhance patient outcomes. Key interventions included the establishment of recurring interdisciplinary meetings with stroke coordinators, development and implementation of a standardized interfacility transfer feedback form, creation of a regional partnership network to support shared learning, and detailed mapping of existing transfer workflows to identify variation and streamline coordination across facilities. Results/Lessons Learned: Baseline door-to-device times averaged 72 minutes, and feedback response rates were below 35%. Following implementation, transfer response times improved by 22% (18.6 to 14.4 minutes), feedback response rates increased by 67% (33% to 55%), and door-to-device times decreased by 35% (72 to 47 minutes). Structured feedback loops and workflow transparency led to reduced delays and more consistent stroke care across sites. Conclusions: The interfacility transfer feedback model significantly improved timeliness, communication, and care coordination across multiple institutions. Embedding structured feedback into transfer workflows promoted consistency, accountability, and operational alignment. Stroke nurses are critical to sustaining these improvements and leading collaboration across systems. Future efforts will focus on expanding the model to additional referring facilities and evaluating its long-term impact on patient-centered outcomes.