The Science of Throughput: Why Minutes Matter in Patient Transfers
By Jennifer Davis, Executive Administrative Assistant @ highMor | August 2025
Introduction
Throughput in hospitals—particularly the time taken for patient transfers between units—has become a key quality benchmark. Research consistently demonstrates that even modest reductions in transfer delays (by 15–30 minutes) can have outsized impacts on patient outcomes, including mortality, readmission rates, and patient satisfaction. This article synthesizes findings from peer-reviewed studies to elucidate these connections and discusses the mechanisms and practicalities underpinning this phenomenon.¹²³⁴⁵⁶
How Transfer Minutes Affect Mortality
Delay exacerbates risk: Each hour of delay in transferring a critical patient to the ICU increases the odds of hospital mortality by 3%. Some studies show this relationship starts linearly as early as a 5-hour wait in the ED, with the death rate increasing by 8–10% among those waiting longer compared to those transferred promptly.⁷⁸⁹⁴⁵¹
Shorter delays yield results: A study simulating streamlined intra-hospital transfer reduced average waiting time by 21.8%, yielding better outcomes for urgent cases.¹⁰
Early recognition and transfer: Early warning systems, like eCART, facilitate prompt transfers and correlate with reduced preventable deaths.⁸¹
Reducing Readmissions by Reducing Transfer Time
Timely discharge and post-transfer coordination: Multimodal interventions (including centralized transfer protocols and post-discharge navigators) reduced early readmissions from 21.5% to 17.8% for targeted conditions.¹¹¹²¹³
30-day readmission linkage: Multiple studies link delayed transfers to increased 30-day readmission rates, with burdens measured in thousands of excess hospitalization days and millions in avoidable costs.¹⁴¹⁵¹⁶
Protocol-driven change: Implementation of structured transfer of care, such as blackout windows or standardized procedures, showed significant reductions in psychiatric and acute care readmissions.¹³¹⁷
Patient Satisfaction and Experience
Wait time is a driver: Longer wait times correlate negatively with all aspects of patient satisfaction, including confidence in providers and perceived quality of care. Shorter waits foster trust and willingness to recommend the hospital.¹⁸¹⁹²⁰²¹
Interdepartmental transfer frequency: Each additional transfer diminishes patient perceptions of the environment and nursing care; stability improves satisfaction scores directly.¹⁸
Patient-centered logistics: Centralized transfer centers and predictive models streamline communication and bed assignment, resulting in happier, less anxious patients.¹⁹²²
Financial & Institutional Implications
Operational costs and penalties: Hospitals that reduce transfer delays benefit financially via decreased length of stay, fewer readmissions, and higher patient experience scores—directly impacting reimbursement under value-based purchasing.¹⁵¹⁶²³¹¹
Resource optimization: Predictive analytics guide where limited resources can have the greatest impact, targeting high-risk or deteriorating patients for expedited transfer.²²
Practical Strategies for Reducing Transfer Delays
Automated alerts (eCART, predictive models)
Centralized transfer centers
Blackout windows prior to staff shift changes to avoid risk-prone transitions
Dedicated discharge coordinators and patient navigators
Data-driven triage to prioritize the most urgent cases
Conclusions
Reducing transfer delays—even by 15–30 minutes—translates to measurable improvements in mortality, greater patient satisfaction, and lowered readmissions. Every minute matters: the science of throughput is clear that operational and technological investments in timely transfers are among the most cost-effective, lifesaving interventions hospitals can undertake.
References
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² Plate JDJ, Peelen LM, Leenen LPH, Hietbrink F. Delayed transfer of critically ill patients from the emergency department is associated with increased mortality. Am J Surg. 2019;218(5):910-916. doi:10.1016/j.amjsurg.2019.02.011
³ Eriksson CO, Stoner RC, Eden KB, Newgard CD, Guise JM. The association between hospital occupancy and outcomes in critically ill children: a population-based cohort study. J Intensive Care Med. 2024;39(2):131-141. doi:10.1177/088506662311748078
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