How to Measure Transfer Center Performance: 6 KPIs That Matter Most

By Jennifer Davis, Executive Administrative Assistant @ highMor | July 2025

In the dynamic world of healthcare, transfer centers and command centers act as vital hubs for coordinating patient movements between facilities, ensuring timely access to specialized care. These centers handle everything from emergency transfers to elective admissions, but their success hinges on effective performance tracking. By focusing on key performance indicators (KPIs), healthcare leaders can identify bottlenecks, optimize workflows, and improve patient outcomes. This article outlines six essential KPIs for evaluating transfer center performance, drawing on recent research to provide actionable insights. These metrics emphasize timeliness, conversion rates, denials, and more, offering a balanced view of operational efficiency and quality.

Why KPIs Are Essential for Transfer Centers

Transfer centers streamline interhospital transfers, reducing delays that can lead to adverse events or extended hospital stays¹ ². Without robust KPIs, it’s challenging to benchmark performance or drive improvements. Research from military and civilian hospitals shows that tracking specific metrics can cut median disposition times by up to 45% and minimize unnecessary denials². Similarly, studies on comprehensive stroke centers highlight how KPIs like door-to-groin times enhance neurointerventional outcomes³ ⁴. By adopting a data-driven approach, centers can boost referral conversions, lower denial rates, and ensure better resource allocation.

KPIs should be measurable, aligned with organizational goals, and regularly reviewed. For instance, a performance improvement project at a military facility reduced transfer process times from 40 minutes to 22 minutes by monitoring key metrics². In civilian settings, analyzing over 116,000 transfer requests revealed trends in acceptance rates and ED utilization, promoting value-based care¹.

The 6 Most Critical KPIs

Based on evidence from quality improvement initiatives and consensus-driven frameworks, here are six KPIs that matter most. These cover operational, clinical, and financial aspects, with practical tips for tracking each.

1. Timeliness of Disposition Decisions

This KPI measures the time from initial transfer request to final acceptance or denial decision. Delays here can prolong patient waits and strain resources. Studies show median times dropping from 40 minutes to 22 minutes after process optimizations, like rapid attending physician contact². In stroke care, off-hours door-to-groin times improved by 39% with augmented intelligence platforms³ ⁴.

  • How to Track: Use call logs to calculate average response times; aim for under 30 minutes.

  • Benchmark: Target a 20–40% reduction in delays to align with high-performing centers³ ².

2. Referral Conversion Rate

Conversion rate tracks the percentage of incoming referrals that result in successful transfers. High rates indicate effective triage and bed matching. Research on over 75,000 accepted transfers found that optimizing this KPI reduced ED reevaluations and improved direct admissions¹. Low conversions often stem from bed shortages or mismatched capabilities.

  • How to Track: Divide completed transfers by total referrals; monitor monthly trends.

  • Benchmark: Strive for 65% or higher, as seen in efficient systems accepting about 65% of requests¹.

3. Transfer Denial Rate

This metric calculates the proportion of requests denied, with breakdowns by reason (e.g., no beds available, medical necessity). Unnecessary denials lead to missed opportunities for care recapture. A study identified medically unnecessary transfers as 40.6% of denials, followed by bed unavailability at 18.9%². Minimizing this rate enhances system-wide efficiency.

  • How to Track: Categorize denials in a database; review quarterly to address root causes.

  • Benchmark: Keep below 35%, focusing on actionable reasons like capacity issues².

4. Acceptance Rate for Direct Admissions 

Focusing on the percentage of requests accepted as direct admits (bypassing ED), this KPI reflects triage adeptness and reduces unnecessary ED visits. Trends show over 50% of accepted patients as direct admits, with declining ED reevaluations over time¹. In critical care, consensus KPIs emphasize equitable improvements through such metrics⁵.

  • How to Track: Compare direct admits to total acceptances; integrate with electronic health records.

  • Benchmark: Aim for 50–60% to optimize workflow and cut costs¹.

5. Patient Outcome Metrics (e.g., Mortality or Readmission Rates)

Beyond operations, this KPI evaluates clinical impact, such as in-hospital mortality or 30-day readmissions post-transfer. Stroke center analyses linked KPI improvements to lower mortality through faster interventions³. Broader research ties effective transfer processes to reduced adverse events⁵.

  • How to Track: Link transfer data to outcome registries; adjust for case complexity.

  • Benchmark: Target reductions of 20–45% in key risks, as demonstrated in sustained improvements³ ⁵.

6. Operational Efficiency (e.g., Call Volume and Resource Utilization)

This measures calls processed per staff member or cost per transfer, highlighting resource use. High volumes with low denials indicate strong performance. A cohort study of 116,000 calls showed temporal reductions in ED utilization, reflecting better resource allocation¹. In military settings, increased call volumes post-improvement signaled enhanced customer service².

  • How to Track: Analyze call logs against staffing data; calculate costs via activity-based accounting.

  • Benchmark: Handle 3,000+ calls monthly with under 20% inefficiency¹ ².

Implementing and Improving with KPIs

To get started, integrate these KPIs into dashboards for real-time monitoring, as used in stroke networks for sustained gains³ ⁴. Conduct regular audits and staff training to address gaps, like those identified in Delphi-based frameworks for critical care transfers⁵. Challenges include data silos, but solutions like standardized collection can overcome them². Ultimately, these metrics foster a culture of continuous improvement, leading to faster transfers, higher satisfaction, and better patient care.

By prioritizing these six KPIs, transfer centers can transform from reactive hubs to proactive engines of efficiency. Healthcare leaders should adapt them to local contexts, using research-backed benchmarks to guide progress and ensure every transfer counts.

References

¹ Dills H, Finley K, Roesler C, et al. Quality performance of a transfer center reduces interhospital delays and adverse outcomes. Lippincott Williams & Wilkins.

² McCafferty R, Bader K, Lim E, et al. Improving the efficiency of a military treatment facility transfer center. Oxford University Press.

³ Arora R, Chang J, Ryu G, et al. VISION-S: Viz.ai implementation of stroke workflows improves door-to-groin times. American Heart Association.

⁴ Migdady I, Meyers P, Sadigh G, et al. VISION: Viz.ai implementation reduces neurointervention delays. American Heart Association.

⁵ Barwise A, Garcia-Arguello L, Hall T, et al. Developing key performance indicators for adult critical care using Delphi methodology. NIH Critical Care Medicine Journal.