Identification and Prevention of Potentially Inappropriate Inter-hospital Transfers (POINT)
Principal Investigator:
Stephanie Mueller, MD, MPH (Brigham and Women’s Hospital)
Inter-hospital transfer (IHT, the transfer of patients from one acute care hospital to another) is common among hospitalized medical patients. Despite this, there is a dearth of guidelines or
data to help direct best practices regarding which patients most benefit from transfer, or conversely, which patients may be exposed to the risks of discontinuity of care without clear benefit from care received following transfer (i.e., undergo potentially inappropriate IHT). Without a reliable method for defining and determining the presence of potentially inappropriate IHT across many organizations, it is not otherwise possible to understand the safety impact of these transfers, to create and optimize future solutions to reduce inappropriate transfers, or to directly test the effects of these solutions on patient outcomes.
The AHRQ-funded Identification and Prevention of Potentially Inappropriate Inter-hospital Transfers study addresses these issues by seeking to accurately define and estimate the incidence and patient safety impact of potentially inappropriate IHT among medical patients who have undergone transfer to a large network of US hospitals, characterize and identify at-risk patients, and develop a toolkit of best practices to reduce potentially inappropriate IHT for future dissemination (e.g., by replacing it with safer alternatives).
Publications:
- Harrison JD, Leykum, LK, Yu A, Kelly C, Mueller SM. From challenges to solutions: A qualitative thematic analysis of inter-hospital transfer processes. G Jen Intern Med. 2025.
- Mueller SK, Kelly C, Singleton S, Leykum L, Harrison JD, Auerbach A, Schnipper JL. Development of a tool to measure potentially inappropriate inter-hospital transfer (IHT): The POINT Study. J Gen Intern Med. 2025;40:1917-1923.
- Mueller SK, Harrison JD, Yu A, Kelly C, Leykum LC. Re-envisioning interhospital transfer: A qualitative study exploring alternatives to transfer. J Hosp Med. 29 May 2025.
Abstracts:
- Mueller S, Singlton S, Mutte M, Lee T, Auerbach A, Schnipper JL. Prevalence and predictors of potentially inappropriate inter-hospital transfers: Early results from the POINT Study. Abstract published at SHM Converge 2026. Abstract 1. Research Plenary.
- Gallagerh K, Marks J, Kubey A. Unnecessary Inter-Hospital Transfers: Exploring Incidence, Reason, Impact, and Improvement Opportunities. Abstract published at SHM Converge 2025. Abstract 0289
- Kelly CM, Mueller SK, Leykum L, Harrison JD. Identification of Potentially Inappropriate Inter-Hospital Transfer. Abstract published at SHM Converge 2024. Abstract 437.
Participating Sites:
University of Colorado
Barnes Jewish Hospital (WUSTL)
University of Rochester Medical Center
University of Wisconsin School of Medicine and Public Health
Oregon Health & Science University
University of Minnesota
Northwestern Memorial Hospital
University of Washington Medicine
Johns Hopkins Hospital
University of Kentucky
Hospital of the University of Pennsylvania
UCSF
University of Chicago
Massachusetts General Hospital
University of New Mexico
Thomas Jefferson University Hospital
