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Child Health Guideline Identifier

Transfer of patients

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To ensure paediatric patients are safely admitted to Starship Hospital.


All Starship staff but specifically:

  • Medical Staff accepting patients from other hospitals
  • Nursing Staff managing ward admissions
  • Duty Managers
  • Children's Emergency Department (CED) triage team (Nursing and Medical)


Patient in another hospital's Emergency Department (ED)

  1. Accepting a patient

    Suitable patient
    Staff member accepting the patient must ensure they are suitable for admission to Starship (age <15 or specific subspecialty contract or current patient of Starship consultant)

    Notify CED
    Staff member accepting patient should ensure CED is aware of expected patient arrival. (Please provide any details known e.g Age, NHI number, presenting problem, mode of transport, contact details of accepting team).
    Phone Ext 24004.
  2. All patients will be assessed and initially managed in CED
    It is anticipated this will involve a combination of staff from CED and the accepting service.

Patient is an inpatient (not in ED) at another hospital

  1. Accepting a patient

    Suitable patient
    As above

    Inpatient Bed Available
    Prior to accepting the transfer of such a patient the accepting staff member must ensure there is an available inpatient bed (discuss with the Duty Manager +/- inpatient nursing shift coordinator).

    If an inpatient bed is not available then transfer should not occur unless the Starship Hospital Full Protocol has been activated and the patients care is unable to continue at the current location.

    Notify CED
    Once a patient has been accepted and a bed booked, the accepting staff member (or delegated team member) must notify CED (Ext 24004) of the expected admission and the location of the inpatient bed.

    Ensure referring hospital have completed the appropriate documentation for National Travel Assistance approval if relevant.
  2. Arrival at Starship
    Patients will present via CED

    All patients will be triaged as per standard CED procedure.

    The relevant inpatient team will be contacted by CED staff (either on-call registrar or consultant).

    Triage Category 1 or 2
    All patients assigned a triage category "1" or "2 will be managed in CED initially and entered on the CHIPS white board.
    - these patients are expected to be managed by the accepting inpatient team and CED staff.
    - Once stable these patients will be transferred to their previously assigned inpatient bed.

    Triage Category 4 or 5
    The inpatient ward will be informed of the arrival of patients assigned a triage category "4" or "5" and the patient will be transferred directly to the inpatient bed (not entered on CHIPS in CED, CED assessment record with hand written name and age and the assigned triage category and triage only documentation completed.)
    - In the instance of a failure of this bed management process, the placement of the patient will be determined by the duty manager, with the understanding that waiting in CED is undesirable and should be regarded as the absolute last resort option.

    Triage Category 3
    Patients assigned a triage category "3" or who the triage team are uncertain about will be rapidly assessed by a medical staff member in CED and a decision will be made to either manage the patient in CED (as per category 1 or 2 above) or transfer the patient to the ward (as per category 4 or 5 above).
  3. Arrival on the ward
    Inpatient team (or relevant delegated on call staff) will review the patient within 1 hour of arrival on the inpatient ward. If this is unable to occur the relevant inpatient consultant will be contacted.

PICU Retrieval

  1. Accepting a patient.
    Generally patients retrieved by the PICU team will go directly to PICU.
     On occasions retrievals will not need to go to PICU, in which case the following steps should occur.

    Inpatient Bed
    This should be arranged by the inpatient team if the patient is unlikely to need PICU. Otherwise this will need to be arranged by the PICU team (via the duty manager) if this becomes apparent during retrieval.
  2. Arrival at Starship

    Triage category 1
    - should go to PICU

    Triage category 2 or 3 - prior to ward transfer, patients will require management in CED or PICU depending on relative resource considerations. Recommend consultant level communication.

    Triage category 4 or 5 - PICU will take patient to the ward and inpatient team notified as per 'Arrival on the Ward' above.

Associated Documents

The ADHB policies and guidelines library on the ADHB intranet also contains a number of documents relating to hospital transfer for ADHB staff only .

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Document Control

  • Date last published: 28 July 2015
  • Document type: Clinical Guideline
  • Services responsible: Children’s Emergency Department
  • Author(s): Mike Shepherd
  • Owner: Mike Shepherd
  • Editor: Greg Williams
  • Review frequency: 2 years
  • Keywords: Inter-hospital transfer

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